PD-(L)1 Inhibitors as Monotherapy for the First-Line Treatment of Non-Small-Cell Lung Cancer Patients with High PD-L1 Expression: A Network Meta-Analysis
Programmed cell death-ligand 1 (PD-L1) has emerged as a potential biomarker for selection of patients more likely to respond to immunotherapy and as a prognostic factor in non-small cell lung cancer (NSCLC). In this network meta-analysis, we aimed to evaluate the efficacy of first-line anti-PD-(L)1...
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doaj-f45d2a2d6192407abbae8c10032547c92021-03-27T00:05:09ZengMDPI AGJournal of Clinical Medicine2077-03832021-03-01101365136510.3390/jcm10071365PD-(L)1 Inhibitors as Monotherapy for the First-Line Treatment of Non-Small-Cell Lung Cancer Patients with High PD-L1 Expression: A Network Meta-AnalysisMargarita Majem0Manuel Cobo1Dolores Isla2Diego Marquez-Medina3Delvys Rodriguez-Abreu4Joaquín Casal-Rubio5Teresa Moran Bueno6Reyes Bernabé-Caro7Diego Pérez Parente8Pedro Ruiz-Gracia9Marta Marina Arroyo10Luis Paz-Ares11Medical Oncology, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, SpainMedical Oncology, Hospital Regional Universitario de Málaga, 29010 Malaga, SpainMedical Oncology, University Hospital Clínico Lozano Blesa, IIS Aragon, 50009 Zaragoza, SpainMedical Oncology, University Hospital Miguel Servet, 50009 Zaragoza, SpainMedical Oncology, Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, SpainMedical Oncology Service, Hospital Álvaro Cunqueiro, 36213 Vigo, SpainMedical Oncology, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, SpainMedical Oncology Department, Hospital Virgen del Rocío, 41013 Seville, SpainMedical Affairs Department, Roche Farma S.A, 28042 Madrid, SpainMedical Affairs Department, Roche Farma S.A, 28042 Madrid, SpainMedical Affairs Department, Roche Farma S.A, 28042 Madrid, SpainMedical Oncology, Hospital 12 de Octubre, 28041 Madrid, SpainProgrammed cell death-ligand 1 (PD-L1) has emerged as a potential biomarker for selection of patients more likely to respond to immunotherapy and as a prognostic factor in non-small cell lung cancer (NSCLC). In this network meta-analysis, we aimed to evaluate the efficacy of first-line anti-PD-(L)1 monotherapy in advanced NSCLC patients with high PD-L1 expression (≥50%) compared to platinum-based chemotherapy. We also evaluated efficacy outcomes according to tumor mutational burden (TMB). To that end, we conducted a systematic review. Six clinical trials with 2111 patients were included. In head-to-head comparisons, immunotherapy showed a significant improvement in progression-free survival (PFS: HR<sub>pooled</sub> = 0.69, 95% CI: 0.52–0.90, <i>p </i>=<i> </i>0.007), overall survival (OS: HR<sub>pooled</sub> = 0.69, 95% CI: 0.61–0.78; <i>p </i><<i> </i>0.001) and overall response rate (ORR) (Risk ratio (RR)<sub>pooled</sub> = 1.354, 95% CI: 1.04–1.762, <i>p </i>=<i> </i>0.024). In the assessment of relative efficacy for PFS through indirect comparisons, pembrolizumab (results from KEYNOTE-024) ranked highest followed by cemiplimab and atezolizumab, with statistical significance determined for some of the drugs. In terms of OS, cemiplimab ranked highest followed by atezolizumab and pembrolizumab, although non-significant OS was determined for these drugs. In conclusion, PD-(L)1 inhibitor monotherapy improves efficacy outcomes in the first line setting of advanced NSCLC patients with high PD-L1 expression. Evaluations with longer follow up are still needed to determine the superiority of any specific drug.https://www.mdpi.com/2077-0383/10/7/1365non-small cell lung cancernetwork meta-analysisimmunotherapyfirst-line treatmentPD-(L)1 inhibitorsefficacy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Margarita Majem Manuel Cobo Dolores Isla Diego Marquez-Medina Delvys Rodriguez-Abreu Joaquín Casal-Rubio Teresa Moran Bueno Reyes Bernabé-Caro Diego Pérez Parente Pedro Ruiz-Gracia Marta Marina Arroyo Luis Paz-Ares |
spellingShingle |
Margarita Majem Manuel Cobo Dolores Isla Diego Marquez-Medina Delvys Rodriguez-Abreu Joaquín Casal-Rubio Teresa Moran Bueno Reyes Bernabé-Caro Diego Pérez Parente Pedro Ruiz-Gracia Marta Marina Arroyo Luis Paz-Ares PD-(L)1 Inhibitors as Monotherapy for the First-Line Treatment of Non-Small-Cell Lung Cancer Patients with High PD-L1 Expression: A Network Meta-Analysis Journal of Clinical Medicine non-small cell lung cancer network meta-analysis immunotherapy first-line treatment PD-(L)1 inhibitors efficacy |
author_facet |
Margarita Majem Manuel Cobo Dolores Isla Diego Marquez-Medina Delvys Rodriguez-Abreu Joaquín Casal-Rubio Teresa Moran Bueno Reyes Bernabé-Caro Diego Pérez Parente Pedro Ruiz-Gracia Marta Marina Arroyo Luis Paz-Ares |
author_sort |
Margarita Majem |
title |
PD-(L)1 Inhibitors as Monotherapy for the First-Line Treatment of Non-Small-Cell Lung Cancer Patients with High PD-L1 Expression: A Network Meta-Analysis |
title_short |
PD-(L)1 Inhibitors as Monotherapy for the First-Line Treatment of Non-Small-Cell Lung Cancer Patients with High PD-L1 Expression: A Network Meta-Analysis |
title_full |
PD-(L)1 Inhibitors as Monotherapy for the First-Line Treatment of Non-Small-Cell Lung Cancer Patients with High PD-L1 Expression: A Network Meta-Analysis |
title_fullStr |
PD-(L)1 Inhibitors as Monotherapy for the First-Line Treatment of Non-Small-Cell Lung Cancer Patients with High PD-L1 Expression: A Network Meta-Analysis |
title_full_unstemmed |
PD-(L)1 Inhibitors as Monotherapy for the First-Line Treatment of Non-Small-Cell Lung Cancer Patients with High PD-L1 Expression: A Network Meta-Analysis |
title_sort |
pd-(l)1 inhibitors as monotherapy for the first-line treatment of non-small-cell lung cancer patients with high pd-l1 expression: a network meta-analysis |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-03-01 |
description |
Programmed cell death-ligand 1 (PD-L1) has emerged as a potential biomarker for selection of patients more likely to respond to immunotherapy and as a prognostic factor in non-small cell lung cancer (NSCLC). In this network meta-analysis, we aimed to evaluate the efficacy of first-line anti-PD-(L)1 monotherapy in advanced NSCLC patients with high PD-L1 expression (≥50%) compared to platinum-based chemotherapy. We also evaluated efficacy outcomes according to tumor mutational burden (TMB). To that end, we conducted a systematic review. Six clinical trials with 2111 patients were included. In head-to-head comparisons, immunotherapy showed a significant improvement in progression-free survival (PFS: HR<sub>pooled</sub> = 0.69, 95% CI: 0.52–0.90, <i>p </i>=<i> </i>0.007), overall survival (OS: HR<sub>pooled</sub> = 0.69, 95% CI: 0.61–0.78; <i>p </i><<i> </i>0.001) and overall response rate (ORR) (Risk ratio (RR)<sub>pooled</sub> = 1.354, 95% CI: 1.04–1.762, <i>p </i>=<i> </i>0.024). In the assessment of relative efficacy for PFS through indirect comparisons, pembrolizumab (results from KEYNOTE-024) ranked highest followed by cemiplimab and atezolizumab, with statistical significance determined for some of the drugs. In terms of OS, cemiplimab ranked highest followed by atezolizumab and pembrolizumab, although non-significant OS was determined for these drugs. In conclusion, PD-(L)1 inhibitor monotherapy improves efficacy outcomes in the first line setting of advanced NSCLC patients with high PD-L1 expression. Evaluations with longer follow up are still needed to determine the superiority of any specific drug. |
topic |
non-small cell lung cancer network meta-analysis immunotherapy first-line treatment PD-(L)1 inhibitors efficacy |
url |
https://www.mdpi.com/2077-0383/10/7/1365 |
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