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2017 ; 8
(35
): 59677-59689
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PD-1/PD-L1 antibodies efficacy and safety versus docetaxel monotherapy in
advanced NSCLC patients after first-line treatment option: systems assessment
#MMPMID28938671
Su Q
; Sun Z
; Zhang C
; Hou Y
; Cao B
Oncotarget
2017[Aug]; 8
(35
): 59677-59689
PMID28938671
show ga
Meta-analysis was conducted to systematically assess the effectiveness and safety
of programmed cell death protein-1 or ligand-1 (PD-1 or PD-L1) antibodies versus
docetaxel alone in advanced non small cell lung cancer (NSCLC). In addition, the
prognostic significance of PD-L1 expression in advanced NSCLC was also
investigated. 5 eligible studies including 3579 patients were identified through
comprehensive search of multiple databases. The results showed that pooled hazard
ratios (HR) for overall survival (OS) and progression free survival (PFS) were
0.69 (95% CI: 0.63-0.75; p < 0.001) and 0.87 (95% CI: 0.80-0.94; p < 0.001),
between PD-1/PD-L1 antibodies and docetaxel treatment arms, respectively. The
pooled relative risk (RR) value for objective response rate (ORR) was 1.53, (95%
CI: 1.16-2.01, p = 0.003). Further, subgroup analysis based on PD-L1 expression
indicated that pooled HR for OS was significant with 0.66(95% CI: 0.59-0.74, p <
0.001) for PD-L1?1%. However, PD-L1 < 1% had HR value of 0.79 (95% CI: 0.67-0.93,
p = 0.006). Our study concluded that advanced NSCLC patients benefited more with
PD-1/PD-L1 antibodies than docetaxel in the second line treatment. PD-L1?10% in
tumor tissues is sufficient to show significant improvement in patient's outcome
with PD-1/PD-L1 antibodies compared to docetaxel. Moreover, PD-1/PD-L1 antibodies
treatment showed significant decrease in conventional chemotherapy adverse
events, but increased immune-associated adverse effects.