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首页> 外文期刊>International Journal of Cancer =: Journal International du Cancer >Looking for the best immune-checkpoint inhibitor in pre-treated NSCLC patients: An indirect comparison between nivolumab, pembrolizumab and atezolizumab
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Looking for the best immune-checkpoint inhibitor in pre-treated NSCLC patients: An indirect comparison between nivolumab, pembrolizumab and atezolizumab

机译：寻找预处理的NSCLC患者的最佳免疫检查点抑制剂：Nivolumab，Pembrolizumab和Atezolizumab之间的间接比较

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摘要

Immune-checkpoint inhibitors represent the new standard of care in patients with advanced NSCLC who progressed after first-line treatment. This work aim to assess any difference in both efficacy and safety profiles among Nivolumab, Pembrolizumab and Atezolizumab in pre-treated NSCLC patients. Randomized clinical trials comparing immune-checkpoint inhibitor versus docetaxel in pre-treated patients with advanced NSCLC were included and direct comparison meta-analysis of selected trials have been performed. Subsequently the summary estimates of Nivolumab, Pembrolizumab and Atezolizumab emerging from the direct meta-analysis were selected to provide the pooled estimates of hazard ratio (HR) and relative risk (RR) for the indirect comparisons among these agents. A total of 5 studies met the selection criteria and were included in the meta-analysis. Indirect comparisons for efficacy outcomes showed the RR for ORR nivolumab versus atezolizumab 1.66 (95% CI 1.07?2.58), pembrolizumab versus atezolizumab 1.94 (95% CI 1.30?2.90). No significant differences in both PFS and OS have been observed. Indirect comparisons for safety showed the RR for G3-5 AEs nivolumab versus pembrolizumab 0.41 (95% CI 0.29?0.60), nivolumab versus atezolizumab 0.50 (95% CI 0.35?0.72). No significant differences in both pneumonitis and discontinuation rate have been observed. The results of this work revealed that nivolumab and pembrolizumab are associated with a significant increase of ORR as compared to atezolizumab and nivolumab is associated with a significant lower incidence of G3-5 AEs as compared to the other drugs. These evidences could support the oncologists to select the best drug for each patient.
机译：免疫检查点抑制剂代表了先进的NSCLC患者的新的护理标准，在一线治疗后进展。这项工作旨在在预处理的NSCLC患者中评估Nivolumab，Pembrolizumab和Atezolizumab的疗效和安全性曲线的任何差异。随机化临床试验比较免疫检查点抑制剂与多西紫杉醇的预审治疗患者进行预处理的NSCLC患者，并进行了对选定试验的直接比较荟萃分析。随后选择从直接荟萃分析中出现的Nivolumab，Pembrolizumab和atezolizumab的概述估计，以提供这些药剂间接比较的危险比（HR）和相对风险（RR）的汇总估计。共有5项研究达到了选择标准，并包括在Meta分析中。疗效结果的间接比较显示了ORR Nivolumab的RR与atezolizumab 1.66（95％Ci 1.07？2.58），Pembrozumab与atezolizumab 1.94（95％Ci 1.30？2.90）。已经观察到PFS和OS中没有显着差异。用于安全性的间接比较显示G3-5 AES Nivolumab的RR与PEMBROLIZUAB 0.41（95％CI0.29≤0.60），Nivolumab与atezolizumab 0.50（95％CI 0.35？0.72）。已经观察到肺炎和停药率没有显着差异。该工作的结果表明，与其他药物相比，Nivolumab和Pembrolizumab与Atezolizumab和Nivolumab相比，与其他药物相比，Nivolumab与Nivolumab的显着较低的发病率相关联。这些证据可以支持肿瘤学家为每位患者选择最佳药物。

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