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The efficacy and safety of immune checkpoint inhibitor plus chemotherapy in patients with advanced non-small-cell lung cancer: a meta-analysis

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Abstract

Objective

To evaluate the efficacy and safety of immune checkpoint inhibitor (ICI) and chemotherapy (CT) versus CT alone in advanced non-small-cell lung cancer (NSCLC).

Methods

Databases (PubMed, Embase and Cochrane Library) were searched for relevant randomized controlled trials (RCTs). Clinical outcome measures including overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and grade 3–5 treatment-related adverse events (AEs) were analyzed by Stata 15.0 software; significance level was 0.05.

Results

Eight RCTs involving 4227 patients were included. The results showed ICI + CT significantly improved OS (hazard ratio [HR] = 0.74, 95% CI: 0.62–0.85, p < 0.001), PFS (HR = 0.66, 95% CI: 0.57 − 0.75, p < 0.001) and ORR (odds ratio [OR] = 1.89; 95% CI, 1.43–2.49, p < 0.001) compared with CT alone. Subgroup analysis indicated that significantly longer OS was also observed in subgroups including combination regimens (pembrolizumab + CT, atezolizumab + CT, ipilimumab + CT, and nivolumab + ipilimumab + CT) and PD-L1 status [negative (< 1%), positive (≥ 1%), low (1–49%) and high (≥ 50%)]. However, ICI + CT showed signifcantly higher grade 3–5 treatment-related AEs than CT (OR = 1.46, 95% CI: 1.19 − 1.79, p < 0.001).

Conclusions

ICI + CT showed better clinical efficacy than CT alone in patients with advanced NSCLC, with increased treatment-related AEs.

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Acknowledgements

The authors would like to thank Binyang County People’s Hospital.

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Authors and Affiliations

  1. Respiratory Department, Binyang County People’s Hospital, Ren-Ai Street No.137, Binyang, Guangxi, China

    Li-Fang Meng

  2. Radiotherapy Department, The Third Affiliated Hospital of Guangxi Medical University, 530000, Nanning, Guangxi, China

    Jian-Feng Huang, Peng-Hui Luo, Shang-Xiao Huang & Han-Lei Wang

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Contributions

L.F. M coordinated the data collection and conceived the original idea. J.F. H provided statistical analysis. L.F. M and P.H. L wrote the manuscript, all other Authors facilitated data collection and critically reviewed the manuscript for important intellectual contents.

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Correspondence to Li-Fang Meng.

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Meng, LF., Huang, JF., Luo, PH. et al. The efficacy and safety of immune checkpoint inhibitor plus chemotherapy in patients with advanced non-small-cell lung cancer: a meta-analysis. Invest New Drugs 40, 810–817 (2022). https://doi.org/10.1007/s10637-022-01232-8

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