The efficacy and safety of anti‐PD‐1/PD‐L1 antibodies combined with chemotherapy or CTLA4 antibody as a first‐line treatment for advanced lung cancer. Issue 11 (25th January 2018)

• Record Type: Journal Article
• Authors: Xu, Xiaoling; Huang, Zhiyu; Zheng, Lei; Fan, Yun
• Is Part Of: International journal of cancer. Volume 142:Issue 11(2018)
• Page Start: 2344
• Page End: 2354
• Publication Date: 2018-01-25
• Subjects: anti‐PD‐1/PD‐L1 antibodies -- anti‐CTLA4 antibodies -- lung cancer -- chemotherapy; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.31252
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : Checkpoint inhibitors show promising efficacy in advanced lung cancer, especially in non‐small‐cell lung cancer (NSCLC). This meta‐analysis was conducted to explore the therapeutic efficacy and safety of anti‐PD‐1/PD‐L1 antibodies combined with chemotherapy or CTLA4 antibody as first‐line treatments for patients with advanced lung cancer. A systematic search was performed in databases for this system review and quantitative meta‐analysis. Twelve trials were finally enrolled in the meta‐analysis. Our analyses revealed that the combined overall response rate (ORR) and disease control rate (DCR) for immune checkpoint inhibitors combined with chemotherapy for the treatment of NSCLC were 47.0% (95% CI: 34.2%‐60.2%) and 80.9% (95% CI: 69.4%‐88.7%), respectively. The combined ORR and DCR for CTLA4 antibody combined with chemotherapy for the treatment of small‐cell lung cancer (SCLC) were 65.4% (61.1%‐69.5%) and 87.6% (84.5%‐90.2%), respectively. The combined six‐month progression‐free survival rates (PFSRs6m ) for NSCLC and SCLC were 50.2% (95% CI: 21.9%‐78.4%) and 30.7% (21.2%‐40.3%), respectively, and the OSRs1y were 56.4% (39.1%‐73.7%) and 36.9% (33.3%‐40.5%), respectively. In addition, the combined ORR and DCR for the checkpoint inhibitors plus CTLA4 antibody treatment group in NSCLC were 29.6% (95% CI: 11.4%‐57.8%) and 48.7% (16.8%‐81.7%), respectively. In subgroup analyses, a significant improvement in PFS was observed in NSCLC and SCLC, with a combined hazard ratio and 95% confidence interval of 0.841 (0.737‐0.961) and 0.856 (0.756‐0.968), respectively. In summary, synergistic activity and an acceptable safety profile were observed with checkpoint inhibitor plus chemotherapy combination treatment in lung cancer. Abstract : What's new? Immune checkpoint inhibitors are effective second‐line agents for the treatment of advanced non‐small‐cell lung cancer (NSCLC). Nonetheless, optimal treatment strategies employing these inhibitors alongside other therapies in NSCLC are yet to be established. The present meta‐analysis examined the efficacy of combination therapies using checkpoint inhibitors targeted against programmed death protein 1 (PD‐1) or its ligand, PD‐L1, with chemotherapy or CTLA4 antibody therapy. Analyses suggest that PD‐1/PD‐L1 inhibitors and chemotherapy act synergistically to improve progression‐free survival but not overall survival. Modest activity and tolerable adverse effects were observed for combined PD‐1/PD‐L1 inhibitor and CTLA4 antibody therapy.