Evidence Synthesis & Decision Modeling, Precision Xtract, Oakland, CA 94612, USA.
Center for Observational & Real World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ 07033, USA.
Immunotherapy. 2019 Apr;11(5):407-428. doi: 10.2217/imt-2018-0193. Epub 2019 Feb 4.
A systematic review and network meta-analysis were conducted to evaluate the efficacy of pembrolizumab + pemetrexed + platinum relative to other regimens in metastatic nonsquamous non-small-cell lung cancer (NSq-NSCLC).
PATIENTS & METHODS: Eligible studies evaluated first-line regimens in NSq-NSCLC patients without known targetable mutations. Relative treatment effects were synthesized with random effects proportional hazards Bayesian network meta-analyses.
The hazard ratio (HR) for overall survival (OS) for pembrolizumab + pemetrexed + platinum was statistically significant over all platinum-doublet (HR range: 0.42-0.61), platinum-doublet + bevacizumab (HR range: 0.44-0.53) and platinum-doublet + atezolizumab regimens (HR range: 0.56-0.62). Additionally, pembrolizumab + pemetrexed + platinum numerically improved OS over atezolizumab + paclitaxel + carboplatin + bevacizumab (HR: 0.65; 95% credible interval: 0.43, 1.01). Pembrolizumab + pemetrexed + platinum had 95.6% probability of being the best treatment regimen for OS.
Pembrolizumab + pemetrexed + platinum is likely the most efficacious first-line regimen for metastatic NSq-NSCLC.
系统评价和网络荟萃分析评估了培美曲塞+顺铂+帕博利珠单抗联合方案与其他方案相比在转移性非鳞状非小细胞肺癌（NSq-NSCLC）中的疗效。
合格的研究评估了无已知可靶向突变的 NSq-NSCLC 患者的一线治疗方案。采用随机效应比例风险贝叶斯网络荟萃分析综合相对治疗效果。
与所有铂类双药（HR 范围：0.42-0.61）、铂类双药+贝伐珠单抗（HR 范围：0.44-0.53）和铂类双药+阿特珠单抗（HR 范围：0.56-0.62）相比，培美曲塞+顺铂+帕博利珠单抗联合方案的总生存期（OS）的风险比（HR）具有统计学意义。此外，培美曲塞+顺铂+帕博利珠单抗联合方案的 OS 改善情况优于阿特珠单抗+紫杉醇+卡铂+贝伐珠单抗（HR：0.65；95%置信区间：0.43，1.01）。培美曲塞+顺铂+帕博利珠单抗联合方案有 95.6%的可能性成为 OS 的最佳治疗方案。
培美曲塞+顺铂+帕博利珠单抗联合方案可能是转移性非鳞状非小细胞肺癌最有效的一线治疗方案。
