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Review

PD-(L)1 Inhibitors in Combination with Chemotherapy as First-Line Treatment for Non-Small-Cell Lung Cancer: A Pairwise Meta-Analysis

1
Medical Oncology Department, University Clinical Hospital of Santiago de Compostela and Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), CIBERONC, 15706 Santiago de Compostela, Spain
2
Medical Oncology Department, Complexo Hospitalario Universitario de Ferrol, 15405 A Coruña, Spain
3
Medical Oncology Department, Centro Oncológico de Galicia, 15009 A Coruña, Spain
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Medical Oncology Department, Complexo Hospitalario Universitario de Ourense, 32005 Ourense, Spain
5
Medical Oncology Department, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain
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Medical Oncology Department, Complexo Hospitalario Universitario de Vigo, 36213 Vigo, Spain
7
Lung Cancer Medical Department, Roche Farma S.A., 28042 Madrid, Spain
8
Medical Oncology Department, Hospital POVISA, 36211 Vigo, Spain
*
Authors to whom correspondence should be addressed.
Shared first authors.
J. Clin. Med. 2020, 9(7), 2093; https://doi.org/10.3390/jcm9072093
Received: 10 June 2020 / Revised: 26 June 2020 / Accepted: 28 June 2020 / Published: 3 July 2020
The combination of programmed cell death-1 (PD-1)/programmed death ligand-1 (PD-L1) inhibitors with chemotherapy has emerged as a promising therapeutic option for advanced non-small-cell lung cancer (NSCLC). The aim of this meta-analysis was to evaluate the efficacy of the combined strategy in this setting. For this purpose, we performed a literature search of randomized controlled trials comparing PD-(L)1 inhibitors plus platinum-based chemotherapy versus chemotherapy alone in stage IV NSCLC patients. Seven clinical trials with 4562 patients were included. In the intention-to-treat wildtype population, PD-(L)1 inhibitor plus chemotherapy was significantly associated with improved progression-free survival (PFS) (Hazard ratio (HR) = 0.61, 95% confidence interval (CI): 0.57–0.65, p < 0.001) and overall survival (OS) (HR = 0.76, 95% CI: 0.67–0.86; p < 0.001) compared to chemotherapy. A significantly higher overall response rate (ORR) was also observed with the combined strategy (Odds ratio (OR) = 2.12, 95% CI: 1.70–2.63, p < 0.001). Furthermore, in all the analyzed subgroups, addition of PD-(L)1 inhibitors to chemotherapy significantly improved efficacy endpoints. Specifically, stratification according to PD-L1 expression revealed a benefit across all patients, regardless of their PFS status. In conclusion, PD-(L)1 blockade added to standard platinum-based chemotherapy significantly improved PFS, OS, and ORR in the up-front treatment of advanced NSCLC. View Full-Text
Keywords: non-small-cell lung cancer; immunotherapy; PD-1 inhibitors; PD-L1 inhibitors; chemotherapy; meta-analysis non-small-cell lung cancer; immunotherapy; PD-1 inhibitors; PD-L1 inhibitors; chemotherapy; meta-analysis
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MDPI and ACS Style

García-González, J.; Ruiz-Bañobre, J.; Afonso-Afonso, F.J.; Amenedo-Gancedo, M.; Areses-Manrique, M.d.C.; Campos-Balea, B.; Casal-Rubio, J.; Fernández-Núñez, N.; Fírvida Pérez, J.L.; Lázaro-Quintela, M.; Pérez Parente, D.; Crama, L.; Ruiz-Gracia, P.; Santomé-Couto, L.; León-Mateos, L. PD-(L)1 Inhibitors in Combination with Chemotherapy as First-Line Treatment for Non-Small-Cell Lung Cancer: A Pairwise Meta-Analysis. J. Clin. Med. 2020, 9, 2093. https://doi.org/10.3390/jcm9072093

AMA Style

García-González J, Ruiz-Bañobre J, Afonso-Afonso FJ, Amenedo-Gancedo M, Areses-Manrique MdC, Campos-Balea B, Casal-Rubio J, Fernández-Núñez N, Fírvida Pérez JL, Lázaro-Quintela M, Pérez Parente D, Crama L, Ruiz-Gracia P, Santomé-Couto L, León-Mateos L. PD-(L)1 Inhibitors in Combination with Chemotherapy as First-Line Treatment for Non-Small-Cell Lung Cancer: A Pairwise Meta-Analysis. Journal of Clinical Medicine. 2020; 9(7):2093. https://doi.org/10.3390/jcm9072093

Chicago/Turabian Style

García-González, Jorge, Juan Ruiz-Bañobre, Francisco J. Afonso-Afonso, Margarita Amenedo-Gancedo, María del Carmen Areses-Manrique, Begoña Campos-Balea, Joaquín Casal-Rubio, Natalia Fernández-Núñez, José Luis Fírvida Pérez, Martín Lázaro-Quintela, Diego Pérez Parente, Leonardo Crama, Pedro Ruiz-Gracia, Lucía Santomé-Couto, and Luis León-Mateos. 2020. "PD-(L)1 Inhibitors in Combination with Chemotherapy as First-Line Treatment for Non-Small-Cell Lung Cancer: A Pairwise Meta-Analysis" Journal of Clinical Medicine 9, no. 7: 2093. https://doi.org/10.3390/jcm9072093

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