Department of Oncology and Southwest Cancer Center, Southwest Hospital, Army Medical University, Chongqing, China.
Artif Cells Nanomed Biotechnol. 2019 Dec;47(1):4194-4201. doi: 10.1080/21691401.2019.1687499.
The present study was performed to investigate the efficacy and safety of anti-programmed death-1 (PD-1)/programmed death-ligand-1 (PD-L1) treatments in non-small cell lung cancer (NSCLC). The potential articles were searched from Pubmed and Embase. The end points included overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and adverse events. < .05 or ≥ 50% meant obvious heterogeneity, and the random-effects model was adopted for pooled analysis, otherwise, the fixed-effects model was used. Subgroup analysis was performed based on the treatment line. Potential publication bias was tested with Begg's funnel plot. Eight eligible articles were included. OS rate of NSCLC patients was prolonged by anti-PD-1/PD-L1 treatments (HR = 0.685, 95%CI = 0.632-0.742), as well as PFS (HR = 0.821, 95%CI = 0.721-0.936). Meanwhile, anti-PD-1/PD-L1 treatments could greatly enhance the ORR (RR = 1.646, 95%CI = 1.382-1.961), with fewer adverse events (RR = 0.800, 95%CI = 0.688-0.931). Subgroup analysis indicated that anti-PD-1/PD-L1 treatments as second-line treatment could significantly improve the survival of patients without adverse events. The overall results were robust, without significant publication bias ( = .532). Anti-PD-1/PD-L1 treatments show better clinical efficacy and higher safety than chemotherapy in NSCLC.
本研究旨在探讨抗程序性死亡-1（PD-1）/程序性死亡配体-1（PD-L1）治疗在非小细胞肺癌（NSCLC）中的疗效和安全性。从 Pubmed 和 Embase 中搜索潜在的文章。终点包括总生存期（OS）、无进展生存期（PFS）、客观缓解率（ORR）和不良事件。<0.05 或≥50%表示存在明显的异质性，采用随机效应模型进行合并分析，否则采用固定效应模型。根据治疗线进行亚组分析。采用 Begg 漏斗图检测潜在的发表偏倚。纳入 8 篇合格文章。抗 PD-1/PD-L1 治疗可延长 NSCLC 患者的 OS 率（HR=0.685，95%CI=0.632-0.742）和 PFS（HR=0.821，95%CI=0.721-0.936）。同时，抗 PD-1/PD-L1 治疗可显著提高 ORR（RR=1.646，95%CI=1.382-1.961），并减少不良事件（RR=0.800，95%CI=0.688-0.931）。亚组分析表明，抗 PD-1/PD-L1 治疗作为二线治疗可显著改善无不良事件患者的生存情况。总体结果稳健，无明显发表偏倚（ = .532）。抗 PD-1/PD-L1 治疗在 NSCLC 中的疗效优于化疗，且安全性更高。
