| Autor: |
García-González J; 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., Ruiz-Bañobre J; 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., Afonso-Afonso FJ; Medical Oncology Department, Complexo Hospitalario Universitario de Ferrol, 15405 A Coruña, Spain., Amenedo-Gancedo M; Medical Oncology Department, Centro Oncológico de Galicia, 15009 A Coruña, Spain., Areses-Manrique MDC; Medical Oncology Department, Complexo Hospitalario Universitario de Ourense, 32005 Ourense, Spain., Campos-Balea B; Medical Oncology Department, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain., Casal-Rubio J; Medical Oncology Department, Complexo Hospitalario Universitario de Vigo, 36213 Vigo, Spain., Fernández-Núñez N; Medical Oncology Department, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain., Fírvida Pérez JL; Medical Oncology Department, Complexo Hospitalario Universitario de Ourense, 32005 Ourense, Spain., Lázaro-Quintela M; Medical Oncology Department, Complexo Hospitalario Universitario de Vigo, 36213 Vigo, Spain., Pérez Parente D; Lung Cancer Medical Department, Roche Farma S.A., 28042 Madrid, Spain., Crama L; Lung Cancer Medical Department, Roche Farma S.A., 28042 Madrid, Spain., Ruiz-Gracia P; Lung Cancer Medical Department, Roche Farma S.A., 28042 Madrid, Spain., Santomé-Couto L; Medical Oncology Department, Hospital POVISA, 36211 Vigo, Spain., León-Mateos L; 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. |
| Abstrakt: |
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. |
