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SYSTEMATIC REVIEW article

Front. Oncol.
Sec. Thoracic Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1455306

Updated Bayesian network meta-analysis on the efficacy and safety of PD-1 versus PD-L1 inhibitors in first-line treatment with chemotherapy for extensive-stage small-cell lung cancer

Provisionally accepted
Ke Wang Ke Wang 1,2Chaungjie Zheng Chaungjie Zheng 1,2Xinrong Chen Xinrong Chen 1,2Penghui Lin Penghui Lin 3Mengge Lin Mengge Lin 3Cuizhen Chen Cuizhen Chen 3Linzhu Zhai Linzhu Zhai 1,3*
  • 1 Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
  • 2 Lingnan Medical Research Centre, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
  • 3 The First Affiliated Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China

The final, formatted version of the article will be published soon.

    Objective: To compare the efficacy and safety of programmed cell death 1 inhibitors plus chemotherapy (PD-1 + Chemo) and programmed cell death ligand 1 inhibitors plus chemotherapy (PD-L1 + Chemo) for the treatment of extensive-stage small-cell lung cancer (ES-SCLC). Methods: We performed a meta-analysis of relevant data using R software, considering overall survival (OS), progression-free survival (PFS), and grade ≥ 3 treatment-related adverse events (TRAES). Results: PD-1 + Chemo (OS: hazard ratio [HR] 0.71; PFS: HR 0.59) and PD-L1 + Chemo (OS: HR 0.72; PFS: HR 0.73) significantly prolonged survival and did not increase the incidence of grade ≥ 3 TRAEs compared with chemotherapy. Indirect comparisons showed no significant difference in clinical efficacy (OS: HR 0.99, 95% CI: 0.86-1.1; PFS: HR 0.80, 95% CI: 0.61-1.0) or safety (HR 1.0, 95% CI: 0.93-1.1) between PD-1 + 2 Chemo and PD-L1 + Chemo. Non-cumulative probability ranking plot ranking results showed that PD-1 + Chemo ranked first in OS and PFS. Patients with PD-L1 expression levels < 1%, PD-1 + Chemo showed a trend of disadvantage (OS: HR 1.3; PFS: HR 1.2), whereas for patients with PD-L1 expression levels ≥ 1%, PD-1 + Chemo showed a trend of advantage (OS: HR 0.85; PFS: HR 0.85). Conclusions: PD-1 + Chemo and PD-L1 + Chemo significantly prolonged OS and PFS in patients with ES-SCLC and did not significantly increase the incidence of grade ≥ 3 TRAES.The efficacy and safety profiles of PD-1 + Chemo and PD-L1 + Chemo appear to be similar.

    Keywords: extensive-stage small-cell lung cancer, efficacy and safety, PD-1 inhibitors, PD-L1 inhibitors, Network meta-analysis

    Received: 26 Jun 2024; Accepted: 27 Dec 2024.

    Copyright: © 2024 Wang, Zheng, Chen, Lin, Lin, Chen and Zhai. 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: Linzhu Zhai, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.