PD-1/PD-L1 抑制剂治疗晚期非小细胞肺癌患者的疗效：一项随机临床试验的荟萃分析。

Efficacy of PD-1/PD-L1 inhibitors in patients with advanced non-small cell lung cancer: A meta-analysis of randomized clinical trials.

机构信息

Department of Pharmacy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.

School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei City, Taiwan.

出版信息

Thorac Cancer. 2019 May;10(5):1176-1181. doi: 10.1111/1759-7714.13060. Epub 2019 Apr 10.

BACKGROUND

This meta-analysis systematically evaluated the efficacy of PD-1 and PD-L1 inhibitors for the treatment of advanced non-small cell lung cancer (NSCLC) and investigated the efficacy of first-line therapy and PD-1 versus PD-L1 inhibitors.

METHODS

PubMed, The Cochrane Library, and Embase were searched up to November 2018 for randomized controlled trials (RCTs) for eligible studies. The outcome of interest was overall survival (OS). The methodology was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Cochrane Collaboration guidelines. Data were pooled by using the random effects model and expressed as hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Heterogeneity was assessed and quantified (I ).

RESULTS

Seven RCTs were included in this study. PD-1/PD-L1 inhibitors achieved superior OS compared to chemotherapy (HR 0.72, 95% CI 0.63-0.82; P < 0.0001). OS was superior in previously treated patients compared to untreated patients (HR 0.69, 95% CI 0.63-0.76; HR 0.82, 95% CI 0.47-1.44, respectively). No significant differences in OS were observed between PD-1 and PD-L1 inhibitors (HR 0.71, 95% CI 0.59-0.86; HR 0.73, 95% CI 0.63-0.84, respectively).

CONCLUSIONS

PD-1/PD-L1 inhibitors significantly prolonged the OS of previously treated patients. No significant differences in OS were observed between PD-1 and PD-L1 inhibitors.

背景

本荟萃分析系统评估了 PD-1 和 PD-L1 抑制剂治疗晚期非小细胞肺癌（NSCLC）的疗效，并探讨了一线治疗和 PD-1 与 PD-L1 抑制剂的疗效。

方法

检索 PubMed、The Cochrane Library 和 Embase，以获取截止 2018 年 11 月的合格研究的随机对照试验（RCT）。主要结局指标为总生存期（OS）。方法学基于系统评价和荟萃分析的首选报告项目以及 Cochrane 协作组指南。使用随机效应模型汇总数据，并表示为风险比（HR）和相应的 95%置信区间（CI）。评估和量化异质性（I ）。

结果

本研究纳入了 7 项 RCT。PD-1/PD-L1 抑制剂与化疗相比，OS 更优（HR 0.72，95%CI 0.63-0.82；P<0.0001）。与未经治疗的患者相比，先前接受过治疗的患者 OS 更长（HR 0.69，95%CI 0.63-0.76；HR 0.82，95%CI 0.47-1.44）。PD-1 和 PD-L1 抑制剂之间的 OS 无显著差异（HR 0.71，95%CI 0.59-0.86；HR 0.73，95%CI 0.63-0.84）。