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首页> 外文期刊>Journal of cellular physiology. >The landscape of immune checkpoint inhibitor plus chemotherapy versus immunotherapy for advanced non-small-cell lung cancer: A systematic review and meta-analysis
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The landscape of immune checkpoint inhibitor plus chemotherapy versus immunotherapy for advanced non-small-cell lung cancer: A systematic review and meta-analysis

机译：免疫抑制剂+检查站的景观先进的化疗和免疫治疗非小细胞肺癌:系统回顾和荟萃分析

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Background: Lung cancer is the leading cause of cancer-related deaths worldwide and the prognosis remains poor. The recent introduction of the immune checkpoint inhibitor (ICI), or plus chemotherapy, both resulted in the survival benefit for patients with advanced non-small-cell lung cancer (NSCLC), but it remains unanswered which is superior. The current study aimed to estimate the comparative efficacy and safety of ICI-chemotherapy versus ICI-monotherapy in advanced NSCLC. Methods: Studies were identified by searching PubMed, Embase, and Cochrane library. The randomized controlled trials (RCTs) that ICI monotherapy or ICI plus chemotherapy compared with chemotherapy in NSCLC were included with available primary endpoints of progression-free survival (PFS), overall survival (OS), objective response rate, or treatment-related adverse events. A fixed-effect or random-effects model was adopted depending on between-study heterogeneity. Results: A total of 20 RCTs involving 12,025 patients with NSCLC were included. Both ICI-monotherapy and ICI-chemotherapy resulted in significantly prolonged survival compared to chemotherapy and the former led to significantly longer PFS. The magnitude of survival benefits appeared to be greatest among those treated with pembrolizumab plus platinum-based chemotherapy (OS, 0.56; PFS, 0.54). Additionally, OS and PFS advantages of ICI therapies were observed in patients with NSCLC with low or high programmed cell death 1 ligand 1 (PD-L1) expression level, but not in intermediate PD-L1 TPS. Conclusions: Pembrolizumab plus platinum-based chemotherapy was recommended as the optimal first-line therapy for advanced patients with NSCLC. Additionally, PD-L1 alone is not recommended as an adequate molecular biomarker to identify eligible patients for routine clinical practice in immunotherapy.
机译：背景:肺癌的主要原因全世界癌症相关死亡和预后仍然是穷人。免疫抑制剂检查站(ICI),或者加上化疗,导致生存对晚期非小细胞患者肺癌(NSCLC),但它仍是个谜这是优越的。估计的比较疗效和安全性ICI-chemotherapy和ICI-monotherapy晚期非小细胞肺癌。通过搜索PubMed、Embase和科克伦图书馆。ICI单一疗法或ICI +化疗相比之下,非小细胞肺癌化疗都包括在内可用的主要终点无进展生存(PFS),整体存活率(OS)、客观反应率或治疗相关的不良事件。或采用根据随机模型之间的异质性。20个相关的涉及12025例非小细胞肺癌患者包括在内。ICI-chemotherapy导致显著长时间比化疗和生存前者导致显著延长PFS。的大小似乎生存利益在那些接受pembrolizumab最大+铂类化疗(OS 0.56;0.54)。非小细胞肺癌患者的治疗观察较低或高细胞程序性死亡配体1(PD-L1)表达水平,但不是在中间PD-L1 TPS。以铂为基础的化疗是推荐最优一线治疗非小细胞肺癌患者。不建议作为一个适当的分子生物标志物识别合格的患者常规免疫治疗的临床实践。

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