Efficacy and safety of PD1/PDL1 blockades versus docetaxel in patients with pretreated advanced non-small-cell lung cancer: a meta-analysis.

BACKGROUND

PD1/PDL1 blockade is a promising treatment for patients with non-small-cell lung cancer (NSCLC). Here, we employed meta-analysis to evaluate the efficacy and safety of PD1/PDL1 blockades for previously treated NSCLC patients.

METHODS

Randomized clinical trials were retrieved by searching electronic databases. Data for HRs, 95% CIs for overall survival (OS), progression-free survival (PFS), and adverse events (AEs) were extracted and pooled.

RESULTS

A total of five randomized controlled trials including 2,910 patients were included in this meta-analysis. Pooled HRs (95% CI) were 0.71 (0.63-0.79, <0.0001) for OS and 0.86 (0.73-1.02) for PFS. In the subgroup analysis, the pooled HR (95% CI) for PFS was 0.82 (0.75-0.91, <0.0001) in patients with high PDL1 expression, but no significant difference was seen in patients with low expression (0.97 [0.76-1.24], =0.82). The pooled RR for treatment-related AEs of all grades was 0.32 (0.27-0.38, <0.00001) compared with the docetaxel arm, while that for grade 3-5 treatment-related AEs in the PD1/PDL1-blockade arm was 0.16 (0.10-0.27, <0.00001).

CONCLUSION

PD1/PDL1 blockades enhanced OS and PFS and led to lower risk of AEs in NSCLC patients. Smoking history and wild-type EGFR were associated with extended OS.