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Efficacy and safety of PD1/PDL1 blockades versus docetaxel in patients with pretreated advanced non-small-cell lung cancer: a meta-analysis

Authors Liu J, Zhong Y, Peng S, Zhou X, Gan X

Received 25 July 2018

Accepted for publication 7 November 2018

Published 3 December 2018 Volume 2018:11 Pages 8623—8632

DOI https://doi.org/10.2147/OTT.S181413

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Justinn Cochran

Peer reviewer comments 3

Editor who approved publication: Dr William Cho


Jixiang Liu, Yulan Zhong, Shanshan Peng, Xiangxiang Zhou, Xin Gan

Department of Respiratory Medicine, The First Affiliated Hospital, Nanchang University, Nanchang, China

Background: PD1/PDL1 blockade is a promising treatment for patients with non-small-cell lung cancer (NSCLC). Here, we employed meta-analysis to evaluate the efficacy and safety of PD1/PDL1 blockades for previously treated NSCLC patients.
Methods: Randomized clinical trials were retrieved by searching electronic databases. Data for HRs, 95% CIs for overall survival (OS), progression-free survival (PFS), and adverse events (AEs) were extracted and pooled.
Results: A total of five randomized controlled trials including 2,910 patients were included in this meta-analysis. Pooled HRs (95% CI) were 0.71 (0.63–0.79, P<0.0001) for OS and 0.86 (0.73–1.02) for PFS. In the subgroup analysis, the pooled HR (95% CI) for PFS was 0.82 (0.75–0.91, P<0.0001) in patients with high PDL1 expression, but no significant difference was seen in patients with low expression (0.97 [0.76–1.24], P=0.82). The pooled RR for treatment-related AEs of all grades was 0.32 (0.27–0.38, P<0.00001) compared with the docetaxel arm, while that for grade 3–5 treatment-related AEs in the PD1/PDL1-blockade arm was 0.16 (0.10–0.27, P<0.00001).
Conclusion: PD1/PDL1 blockades enhanced OS and PFS and led to lower risk of AEs in NSCLC patients. Smoking history and wild-type EGFR were associated with extended OS.

Keywords:
non-small-cell lung cancer, checkpoint immunologic treatments, PD1, PDL1, meta-analysis

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