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ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 15 - 2024 |
doi: 10.3389/fphar.2024.1516735
This article is part of the Research Topic Clinical Pharmacist Service Promotes the Improvement of Medical Quality Volume II View all 33 articles
A network comparison on efficacy and safety profiling of PD-1/PD-L1 inhibitors in first-line treatment of advanced non-small cell lung cancer
Provisionally accepted- 1 Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- 2 Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- 3 Department of Radiation Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
OBJECTIVE: PD-1/PD-L1 inhibitors are novel immunotherapeutic agents that have been approved for first-line treatment in advanced non-small cell lung cancer (NSCLC). This study aims to evaluate the efficacy and safety of PD-1/PD-L1 inhibitors, which have completed phase 3 clinical trials, as a first-line treatment in patients with advanced NSCLC. MATERIALS AND METHODS: A systematic search of PubMed, Embase and the Cochrane Library was performed to extract eligible literature up to October 2023. Findings included overall survival (OS) , objective response rate (ORR), progression-free survival (PFS), and grade ≥3 treatmentrelated adverse events (TRAEs). Furthermore, subgroup analyses were conducted based on PD-L1 expression levels and histological type.We analyzed 29 studies including 18885 patients. In analyses of all patients, penpulimab plus chemotherapy led the way for OS (HR 0.55, 95% CI : 0.40-0.75) and PFS (HR 0.43, 95% CI : 0.27-0.67). Regarding OS, for patients with PD-L1 expression ≥50%, 1-49% and <1%, camrelizumab + chemotherapy (HR 0.48, 95% CI : 0.21-1.11), cemiplimab + chemotherapy (HR 0.50, 95% CI : 0.32-0.79) and nivolumab + ipilimumab (HR 0.64, 95% CI : 0.51-0.81) were considered optimal treatments. Compared with chemotherapy, monotherapy with nivolumab, cemiplimab, pembrolizumab, atezolizumab and durvalumab had lower odds of TRAE grade ≥3.CONCLUSIONS: In all patients, penpulimab plus chemotherapy was the most effective therapy, but treatment preferences varied by PD-L1 expression, histology type and associated outcomes. Safety at the individual patient level must be a high priority in the decision-making process. Further validation is warranted.
Keywords: programmed death-ligand 1, Non-small cell lung cancer, immune checkpoint inhibitors, PD-1/PD-L1 inhibitors, Network meta-analysis. 2.2 Eligibility criteria
Received: 24 Oct 2024; Accepted: 10 Dec 2024.
Copyright: © 2024 FU, Yan, Wa, Ma and Su. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xu Wa, Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200333, China
Xiumei Ma, Department of Radiation Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Yingjie Su, Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200333, China
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