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2016 ; 7
(45
): 74350-74361
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gab.com Text
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The efficacy and potential predictive factors of PD-1/PD-L1 blockades in
epithelial carcinoma patients: a systematic review and meta analysis
#MMPMID27542277
Yang Y
; Pang Z
; Ding N
; Dong W
; Ma W
; Li Y
; Du J
; Liu Q
Oncotarget
2016[Nov]; 7
(45
): 74350-74361
PMID27542277
show ga
BACKGROUND: This systematic analysis aims to assess the efficacy of PD-1/PD-L1
blockades compared with non-PD-1/PD-L1 therapy and investigate the potential
predictive factors in epithelial carcinoma patients. RESULTS: A total of 11
trials with 6716 patients of melanoma, non-small cell lung cancer (NSCLC) and
renal cell carcinoma (RCC) were included. The pooled HRs (95%CI) were 0.67 (0.62,
0.73), p < 0.001 for OS and 0.66 (0.57, 0.76), p < 0.001 for PFS. In subgroup
analyses, HRs were 0.58 (0.50, 0.66), p < 0.001 in PD-L1 ? 1% group, 0.75 (0.63,
0.89), p = 0.001 in PD-L1 < 1% group for OS and 0.59 (0.48, 0.72), p < 0.001 in
PD-L1 ? 1% group, 0.80 (0.59, 1.07), p = 0.136 in PD-L1 < 1% group for PFS. The p
values of pooled HRs for OS in different age, sex and ECOG score groups were less
than 0.001. In NSCLC patients, aggregated HRs for OS were 1.40 (0.92, 2.12), p =
0.114 in EGFR mutant group and 0.88 (0.59, 1.32), p = 0.536 in never smokers.
METHODS: A systematic search from January 2010 to April 2016 was conducted for
eligible clinical trials. Based on the data of hazard ratios (HRs) and 95%
confidence intervals (CIs) for overall survival (OS) and progression-free
survival (PFS), we assessed the pooled HRs and proposed the subgroup analyses.
CONCLUSIONS: PD-1/PD-L1 blockades prolonged OS and PFS in epithelial carcinoma
patients. PD-L1 expression was a predictive factor for PFS but not predictive for
OS. Age, sex and ECOG score were excluded to predict any of the efficacy
endpoints. Smoking history and EGFR wild type were associated with extended OS in
NSCLC patients.