First‐line immune‐based combination therapies for advanced non‐small cell lung cancer: A Bayesian network meta‐analysis. (7th November 2021)

• Record Type: Journal Article
• Authors: Mao, Ziyang; Jiang, Panpan; Zhang, Yajuan; Li, Yanlin; Jia, Xiaohui; Wang, Qinyang; Jiao, Min; Jiang, Lili; Shen, Yuan; Guo, Hui
• Is Part Of: Cancer medicine. Volume 10:Number 24(2021)
• Page Start: 9139
• Page End: 9155
• Publication Date: 2021-11-07
• Subjects: efficacy -- immune‐based combination therapies -- network meta‐analysis -- non‐small cell lung cancer -- safety; 616.994005
• DOI: 10.1002/cam4.4405
• Languages: English
• ISSNs: 2045-7634

Abstract

Abstract: Background: Immune‐based combination therapies have revolutionized the first‐line treatment for advanced non‐small cell lung cancer (NSCLC). However, for the efficacy and safety, the best treatment option is still uncertain. Methods: We conducted a Bayesian network meta‐analysis of randomized controlled trials (RCTs) to evaluate first‐line immune‐based combination therapies for advanced NSCLC. Results: Fourteen trials involving 8467 patients were included. For the programmed cell death‐ligand 1 (PD‐L1) expression non‐selective patients, there were no significant differences among all the treatment modes for overall survival (OS), but the ranking profiles indicated that Immunotherapy + Immunotherapy + Chemotherapy (IO + IO + Chemo) was most likely to be the best mode (probability = 68%). Immunotherapy + Immunotherapy + Anti‐angiogenic therapy + Chemotherapy (IO + Anti‐angio + Chemo) was significantly better than most other treatment modes for progression‐free survival (PFS) with better objective response rate (ORR) and more obvious grade ≥3 treatment‐related adverse events (TRAEs). In PD‐L1‐high cohort, IO + Anti‐angio + Chemo seemed to be the best mode for OS, PFS, and ORR according to the ranking profiles. In PD‐L1‐intermediate and PD‐L1‐negative cohort, IO + IO + Chemo was inclined to be ranked first for prolonging OS (probability = 78%; 37%) and IO + Anti‐angio + Chemo was most likely to provide best PFS (probability = 96%; 100%). Conclusion: IO + IO + Chemo has great potential to improve the OS regardless of histology type, especially in PD‐L1‐intermediate and PD‐L1‐negative cohort. IO + Anti‐angio + Chemo shows great superiority in improving the short‐term survival accompanied by increasing grade ≥3 TRAEs. Abstract : IO + IO + Chemo has great potential to be recommended to improve OS regardless of the histology type especially in PD‐L1‐intermediate and PD‐L1‐negative cohort. IO + Anti‐angio + Chemo shows great superiority in improving the short‐term survival accompanied by relatively increasing TRAEs. Our findings are of great significance for the first‐line treatment of advanced NSCLC and provide reference for clinicians and patients to achieve precise therapy.