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10.21037/jtd.2017.03.104

http://scihub22266oqcxt.onion/10.21037/jtd.2017.03.104
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C5393989!5393989!28449473
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suck abstract from ncbi


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pmid28449473      J+Thorac+Dis 2017 ; 9 (3): 655-65
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  • Anti-PD-1/PD-L1 antibody versus conventional chemotherapy for previously-treated, advanced non-small-cell lung cancer: a meta-analysis of randomized controlled trials #MMPMID28449473
  • Zhuansun Y; Huang F; Du Y; Lin L; Chen R; Li J
  • J Thorac Dis 2017[Mar]; 9 (3): 655-65 PMID28449473show ga
  • Background: The anti-PD-1/PD-L1 monoclonal antibody has showed promising results in various cancers via enhancing T cell functions. However, many questions remain in the role and safety in previously-treated, advanced non-small-cell lung cancer (NSCLC). Thus, we conducted a meta-analysis incorporating all available evidences to evaluate the efficacy and safety of anti-PD-1/PD-L1 antibody compared with chemotherapy. Methods: PubMed, Web of Science and the Cochrane Library database were searched for the studies about the efficacy and safety of anti-PD-1/PD-L1 antibody in previously-treated, progressive NSCLC patients. Only randomized controlled trials (RCTs) comparing anti-PD-1/PD-L1 antibody with conventional chemotherapy in NSCLC were included. Overall survival (OS) in the intention-to-treat population was the primary outcome. The secondary outcomes were: progression-free survival (PFS) in the intention-to-treat population, objective response rate (ORR), the incidence of adverse events, OS and PFS in different PD-L1 expression subgroups. Results: Four trials with a total of 2,174 patients were included. Anti-PD-1/PD-L1 antibody showed a significant benefit to OS in the intention-to-treat population [combined hazard ratio (HR) 0.67; 95% CI: 0.61?0.75, P<0.00001], a 33% reduction in the relative risk of death. PFS also favored anti-PD-1/PD-L1 antibody (HR 0.81, 95% CI: 0.70?0.95, P=0.009). The ORR was significantly higher with anti-PD-1/PD-L1 antibody than those with chemotherapy (RR of nonresponse, 0.92; 95% CI: 0.89?0.95, P<0.00001). Anti-PD-1/PD-L1 antibody was associated with greater efficacy than chemotherapy across the end points of OS and PFS when tumor PD-L1 expression scored ?1%, ?5%, and ?50%, except for tumor PD-L1 expression scored <1%. The group receiving anti-PD-1/PD-L1 antibody had lower rates of treatment-related adverse events of any grade (RR 0.77; 95% CI: 0.73?0.81, P<0.00001) and treatment-related adverse events of grade 3?5 (RR 0.24; 95% CI: 0.14?0.41, P<0.00001). Conclusions: Anti-PD-1/PD-L1 antibody significantly improved survival compared with chemotherapy in previously-treated, progressive NSCLC patients. Besides, it also had a better safety profile.
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