Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Emory Vaccine Center, Department of Microbiology and Immunology, Emory University, Atlanta, Georgia.
Cancer. 2018 Jan 15;124(2):271-277. doi: 10.1002/cncr.31043. Epub 2017 Sep 28.
Monoclonal antibodies against programmed cell death protein 1 (PD-1) and programmed death ligand 1 (PD-L1) are effective therapies in patients with non-small cell lung cancer (NSCLC). Herein, the authors performed a systematic review investigating differences in the toxicities of PD-1 and PD-L1 inhibitors.
An electronic literature search was performed of public databases (MEDLINE, Excerpta Medica dataBASE [EMBASE], and Cochrane) and conference proceedings for trials using PD-1 inhibitors (nivolumab and pembrolizumab) and PD-L1 inhibitors (atezolizumab, durvalumab, and avelumab) in patients with NSCLC. A formal systematic analysis was conducted with Comprehensive Meta-Analysis software (version 2.2). Clinical and demographic characteristics, response, and toxicity data were compared between both groups.
A total of 23 studies reported between 2013 and 2016 were eligible for analysis. The total number of patients evaluated for toxicities was 3284 patients in the PD-1 group and 2460 patients in the PD-L1 group. The baseline patient characteristics of the 2 groups were similar, although there was a trend toward increased squamous histology in the group treated with PD-L1 (32% vs 25%; P = .6). There was no difference in response rate noted between PD-1 (19%) and PD-L1 (18.6%) inhibitors (P = .17). The incidence of overall adverse events (AEs) was comparable between the PD-1 and PD-L1 inhibitors (64% [95% confidence interval (95% CI), 63%-66%] vs 66% [95% CI, 65%-69%]; P = .8). Fatigue was the most frequently reported AE with both classes of drugs. Patients treated with PD-1 inhibitors were found to have a slightly increased rate of immune-related AEs (16% [95% CI, 14%-17%] vs 11% [95% CI, 10%-13%]; P = .07) and pneumonitis (4% [95% CI, 3%-5%] vs 2% [95% CI, 1%-3%]; P = .01) compared with patients who received PD-L1 inhibitors.
In this systematic review involving 5744 patients with NSCLC, the toxicity and efficacy profiles of PD-1 and PD-L1 inhibitors appear to be similar. Cancer 2018;124:271-7. © 2017 American Cancer Society.
程序性细胞死亡蛋白 1（PD-1）和程序性死亡配体 1（PD-L1）的单克隆抗体在非小细胞肺癌（NSCLC）患者中是有效的治疗方法。在此，作者进行了一项系统评价，以研究 PD-1 和 PD-L1 抑制剂毒性的差异。
对公共数据库（MEDLINE、Excerpta Medica dataBASE [EMBASE]和 Cochrane）和临床试验会议记录进行了电子文献检索，以评估用于 NSCLC 患者的 PD-1 抑制剂（nivolumab 和 pembrolizumab）和 PD-L1 抑制剂（atezolizumab、durvalumab 和 avelumab）的试验。使用 Comprehensive Meta-Analysis 软件（版本 2.2）进行了正式的系统分析。比较了两组患者的临床和人口统计学特征、反应和毒性数据。
2013 年至 2016 年期间共进行了 23 项研究，其中有 23 项研究符合分析条件。在 PD-1 组中，有 3284 名患者评估了毒性，在 PD-L1 组中，有 2460 名患者评估了毒性。两组患者的基线特征相似，但 PD-L1 组的鳞状组织学比例有增加趋势（32%比 25%；P =.6）。PD-1（19%）和 PD-L1（18.6%）抑制剂之间的反应率无差异（P =.17）。PD-1 和 PD-L1 抑制剂的总体不良事件（AE）发生率相似（64%[95%置信区间（95%CI），63%-66%]比 66%[95%CI，65%-69%]；P =.8）。疲乏是两种药物最常报告的 AE。与接受 PD-L1 抑制剂治疗的患者相比，接受 PD-1 抑制剂治疗的患者免疫相关 AE 的发生率略有增加（16%[95%CI，14%-17%]比 11%[95%CI，10%-13%]；P =.07）和肺炎（4%[95%CI，3%-5%]比 2%[95%CI，1%-3%]；P =.01）。
在这项涉及 5744 名 NSCLC 患者的系统评价中，PD-1 和 PD-L1 抑制剂的毒性和疗效谱似乎相似。癌症 2018;124:271-7. © 2017 美国癌症协会。
