Department of Biostatistics, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai 200032, People's Republic of China.
Department of Preventive Medicine, Fudan University, Shanghai 200032, People's Republic of China.
Sci Rep. 2016 Aug 25;6:32020. doi: 10.1038/srep32020.
Immunotherapy is a novel treatment for advanced non-small cell lung cancer (NSCLC) patients. Immunotherapy includes two main broad classes of therapeutic vaccines and immune checkpoint inhibitors, as well as cytokines, biological response modifiers and cellular therapy. The present systematic review and meta-analysis aims to evaluate the efficacy and safety of different classes of immunotherapy in patients with advanced NSCLC. Literature search was done on Medline, Embase and Cochrane Library. The primary endpoints were overall survival (OS) and grade ≥3 adverse events. Twenty randomized controlled trials were finally identified in our study. Efficacy analysis indicated an improvement of OS in advanced NSCLC patients after treating by therapeutic vaccines and immune checkpoint inhibitors, but not for other immunomodulators. Safety analysis showed that immunotherapy was well-tolerated. All kinds of grade ≥3 adverse events were similar between experimental group and control group except that neutropenia and thrombocytopenia had a higher incidence in patients received vaccines. In conclusion, immunotherapy is a promising treatment for advanced NSCLC patients. Our findings will be further confirmed and supplemented by several phase II and phase III RCTs which are going to complete in near future.
免疫疗法是一种治疗晚期非小细胞肺癌（NSCLC）患者的新方法。免疫疗法包括两种主要的治疗性疫苗和免疫检查点抑制剂，以及细胞因子、生物反应调节剂和细胞疗法。本系统评价和荟萃分析旨在评估不同类型的免疫疗法在晚期 NSCLC 患者中的疗效和安全性。文献检索在 Medline、Embase 和 Cochrane Library 上进行。主要终点是总生存期（OS）和≥3 级不良事件。本研究最终确定了 20 项随机对照试验。疗效分析表明，治疗性疫苗和免疫检查点抑制剂可改善晚期 NSCLC 患者的 OS，但其他免疫调节剂则不然。安全性分析表明，免疫疗法具有良好的耐受性。除疫苗组中性粒细胞减少和血小板减少发生率较高外，实验组和对照组的各种≥3 级不良事件相似。总之，免疫疗法是治疗晚期 NSCLC 患者的一种有前途的方法。我们的发现将通过几项即将在不久的将来完成的 II 期和 III 期 RCT 进一步证实和补充。
