Systematic Review and Network Meta-Analysis of Immune Checkpoint Inhibitors in Combination with Chemotherapy as a First-Line Therapy for Extensive-Stage Small Cell Carcinoma
Abstract
:Simple Summary
Abstract
1. Introduction
2. Results
2.1. Literature Search
Study Characteristics and Quality Evaluation
2.2. Pooled Results for ICIs and Their Effect on Efficacy and Safety
Efficacy and Safety Evaluation from the Network Meta-Analysis
2.3. Efficacy and Safety Evaluation
3. Discussion
4. Methods
4.1. Search Strategy and Study Selection
4.2. Data Extraction and Quality Assessment
4.3. Data Synthesis and Statistical Analysis
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Trial Name | ICI-Based Treatment | Year | Phase | Age ≥ 65 (%) | Males (%) | Brain or CNS * Meta (%) | Experimental Arm 1 (Number) | Experimental Arm 2 (Number) | Control Arm (Number) | Criteria for Progression or Response | Criteria for AE * |
---|---|---|---|---|---|---|---|---|---|---|---|
PD-1 inhibitors | |||||||||||
Keynote-604 | pembrolizumab | 2020 | 3 | 52.3% | 64.9% | 12.14% | (n = 228) | (n = 225) | RECIST * | CTCAE * | |
[18] | Induction: 4 × 21 days cycle | EP alone | version 1.1 | ||||||||
Pembrolizumab + EP * | 4 × 21 days cycle | ||||||||||
maintenance * | |||||||||||
pembrolizumab every 3 weeks | |||||||||||
EA5161 | nivolumab | 2020 | 2 | unknown | 44.4% | 11.25% | (n = 80) | (n = 80) | RECIST | CTCAE | |
[14] | median | induction: 4 × 21 days cycle | EP alone | version 1.1 | |||||||
Age = 65 | Nivolumab + EP | 4 × 21 days cycle | |||||||||
maintenance * | |||||||||||
nivolumab every 2 weeks | |||||||||||
PD-L1 inhibitors | |||||||||||
IMpower133 | atezolizumab | 2018 | 3 | 46.2% | 64.8% | 8.68% | (n = 201) | (n = 202) | RECIST | CTCAE | |
[13] | induction: 4 × 21 days cycle | EP alone | version 1.1 | ||||||||
atezolizumab + EP | 4×21 days cycle | ||||||||||
maintenance * | |||||||||||
atezolizumab every 3 weeks | |||||||||||
CASPIAN | durvalumab | 2019 | 3 | 39.7% | 69.6% | 10.24% | (n = 268) | (n = 268) | (n = 269) | RECIST | CTCAE |
[15] | induction: 4 × 21 days cycle | induction: 4 × 21 days cycle | EP alone | version 1.1 | |||||||
durvalumab + EP | durvalumab + EP + tremelimumab | 4 × 21 days cycle | |||||||||
Maintenance * | Maintenance * | ||||||||||
durvalumab every 4 weeks | durvalumab every 4 weeks | ||||||||||
CTLA4 inhibitors | |||||||||||
CA184-041 | ipilimumab | 2013 | 2 | 23.1% | 78.4% | unknown | (n = 42) | (n = 42) | (n = 45) | 1. mWHO * | CTCAE |
[16] | phase regman 6 × 21 days cycle | concurrent regman 6 × 21 days cycle | paclitaxel + carboplatin 4 × 21 days cycle | ||||||||
paclitaxel + carboplatin at cycle 1–2 | ipilimumab +paclitaxel + | 2. irRC * | |||||||||
ipilimumab +paclitaxel + carboplatin at cycle 3–6 | carboplatin at cycle 1–4 | ||||||||||
paclitaxel + carboplatin at cycle 5–6 | |||||||||||
maintenance * | maintenance * | ||||||||||
ipilimumab every 12 weeks | ipilimumab every 12 weeks | ||||||||||
CA184-156 | ipilimumab | 2016 | 3 | 39.6% | 56.9% | 10.48% | (n = 478) | (n = 476) | 1. mWHO | CTCAE | |
[17] | phase regman: 6 × 21 days cycle | EP alone 4 × 21 days cycle | |||||||||
EP at cycle 1–2 | 2. irRC | ||||||||||
ipilimumab + EP at cycle 3–6 | |||||||||||
maintenance * | |||||||||||
Ipilimumab every 12 weeks |
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Chen, H.-L.; Tu, Y.-K.; Chang, H.-M.; Lee, T.-H.; Wu, K.-L.; Tsai, Y.-C.; Lee, M.-H.; Yang, C.-J.; Hung, J.-Y.; Chong, I.-W. Systematic Review and Network Meta-Analysis of Immune Checkpoint Inhibitors in Combination with Chemotherapy as a First-Line Therapy for Extensive-Stage Small Cell Carcinoma. Cancers 2020, 12, 3629. https://doi.org/10.3390/cancers12123629
Chen H-L, Tu Y-K, Chang H-M, Lee T-H, Wu K-L, Tsai Y-C, Lee M-H, Yang C-J, Hung J-Y, Chong I-W. Systematic Review and Network Meta-Analysis of Immune Checkpoint Inhibitors in Combination with Chemotherapy as a First-Line Therapy for Extensive-Stage Small Cell Carcinoma. Cancers. 2020; 12(12):3629. https://doi.org/10.3390/cancers12123629
Chicago/Turabian StyleChen, Hsiao-Ling, Yu-Kang Tu, Hsiu-Mei Chang, Tai-Huang Lee, Kuan-Li Wu, Yu-Chen Tsai, Mei-Hsuan Lee, Chih-Jen Yang, Jen-Yu Hung, and Inn-Wen Chong. 2020. "Systematic Review and Network Meta-Analysis of Immune Checkpoint Inhibitors in Combination with Chemotherapy as a First-Line Therapy for Extensive-Stage Small Cell Carcinoma" Cancers 12, no. 12: 3629. https://doi.org/10.3390/cancers12123629