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2017 ; 8
(34
): 57826-57835
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The efficacy of anti-PD-1/PD-L1 therapy and its comparison with EGFR-TKIs for
advanced non-small-cell lung cancer
#MMPMID28915714
Sheng Z
; Zhu X
; Sun Y
; Zhang Y
Oncotarget
2017[Aug]; 8
(34
): 57826-57835
PMID28915714
show ga
PURPOSE: To better understand the efficacy and safety of anti-PD-1/PD-L1 therapy
(atezolizumab, pembrolizumab, nivolumab) in patients with previously treated
advanced non-small-cell lung cancer (NSCLC). METHODS: The Cochrane Controlled
Trial Register, Embase, Medline, and the Science Citation Index were searched for
prospective published reports of atezolizumab, pembrolizumab, nivolumab in
previously treated patients with advanced NSCLC. RESULTS: Finally, we identified
14 prospective published reports including four trials of atezolizumab covering
542 subjects, three trials of pembrolizumab covering 1566 subjects, seven trials
of nivolumab covering 1678 subjects. When compared to docetaxel, anti-PD-1/PD-L1
therapy could significantly improve overall survival (hazard ratio [HR] 0.67,
P<0.001) and progression-free survival (HR 0.83, P=0.002) for previously treated
patients with advanced NSCLC. Anti-PD-1/PD-L1 therapy produced an overall
response rate of 19% in the 2374 evaluable patients. When using docetaxel as the
common comparator, indirect comparison of anti-PD-1/PD-L1 therapy versus
EGFR-TKIs showed progression-free survival benefit (HR 0.62, P<0.001) and overall
survival benefit (HR 0.60, P<0.001) for those patients with EGFR wild-type.
Meanwhile, for those EGFR mutant patients, indirect comparison indicated that
anti-PD-1/PD-L1 therapy was inferior to EGFR-TKIs therapy in terms of
progression-free survival (HR 3.20, P<0.001), but no survival difference (HR
1.30, P=0.18). CONCLUSION: Anti-PD-1/PD-L1 therapy could produce progression-free
survival and overall survival improvement over docetaxel for patients with
previously treated NSCLC. For EGFR wild-type patients, anti-PD-1/PD-L1 therapy
seemed to prolong progression-free survival and overall survival when compared to
EGFR-TKIs. Meanwhile, for these EGFR mutant patients, anti-PD-1/PD-L1 therapy was
inferior to EGFR-TKIs therapy in terms of progression-free survival.