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Efficacy and safety of programmed death 1 inhibitors in patients with advanced non-small cell lung cancer: a meta-analysis

Authors Liu Y, Zhou S, Du Y, Sun L, Jiang H, Zhang B, Sun G, Wang R

Received 4 November 2018

Accepted for publication 11 April 2019

Published 21 May 2019 Volume 2019:11 Pages 4619—4630


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Kenan Onel

Yi Liu,1,* Sijing Zhou,2,* Yongsheng Du,3,* Li Sun,1 Huihui Jiang,1 Binbin Zhang,1 Gengyun Sun,1 Ran Wang1

1Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China; 2Hefei Prevention and Treatment Center for Occupational Diseases, Hefei 230022, People’s Republic of China; 3Department of General Medicine, Hefei Second People’s Hospital, Hefei 230022, People’s Republic of China

*These authors contributed equally to this work

This study aims to perform systematic review and meta-analysis of all randomized controlled trials that compare the efficacy and safety of programmed death 1 (PD-1) inhibitors versus chemotherapy alone in previously untreated advanced non-small cell lung cancer (NSCLC).
Materials and methods: Several databases, including Medline, Cochrane Library, Embase, and Web of Science, were searched. The main outcome measures included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs).
Results: The results of meta-analysis are expressed as the hazard ratio (HR) or risk ratio (RR) with their corresponding 95% confidence intervals (CIs). The final analysis included six trials for 3,930 patients. PD-1 inhibitors led to a statistically superior survival benefit over chemotherapy in patients with advanced NSCLC. OS was longer in patients who received PD-1 inhibitors (HR =0.71, 95% CI =0.62–0.74, P=0.000). Furthermore, PD-1 inhibitors had significantly higher objective response rate than chemotherapy (RR =0.20,95% CI =0.17–0.23, P=0.000). Meta-analysis showed that the AEs of any grade with PD-1 inhibitors were lower than those with chemotherapy (RR =0.78; 95% CI =0.75–0.81, P=0.000).
Conclusion: PD-1 inhibitors showed a clinically meaningful survival benefit and an improved safety profile in patients with previously treated NSCLC.

Keywords: programmed death 1, lung cancer, efficacy, safety

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