Chen Jiarui, Liu Xingyu, Zhang Junhong, Huang Zhao, Zeng Wei, Hu Jing, Chen Gang, Gong Yan, Liu Yu, Xie Conghua
Department of Radiation & Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.
Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.
Future Oncol. 2022 Apr;18(13):1651-1664. doi: 10.2217/fon-2021-0838. Epub 2022 Feb 7.
To review the efficacy and safety of regimens containing anti-PD-1/PD-L1 and bevacizumab for patients with advanced nonsquamous, non-small-cell lung cancer. Sixteen eligible trials were assessed. Clinical outcomes and adverse events were integrated. Subgroup analysis was conducted according to PD-L1 expression and liver metastases. For the PD-L1 high population, a PD-1 inhibitor plus platinum-doublet provided significant progression-free survival (PFS) benefit versus bevacizumab. While for patients harboring PD-L1 <50%, anti-PD-1/PD-L1-containing regimens performed comparably to bevacizumab. With regard to the liver metastatic population, there existed a trend that anti-PD-1 plus chemotherapy brought about PFS benefits. The preference for chemoimmunotherapy lacks sufficient evidence in patients harboring PD-L1 <50%. Direct head-to-head clinical trials are warranted to identify optimal therapeutic regimens for specific patients.
回顾含抗程序性死亡蛋白1（PD-1）/程序性死亡配体1（PD-L1）和贝伐单抗的治疗方案用于晚期非鳞状非小细胞肺癌患者的疗效和安全性。评估了16项符合条件的试验。整合了临床结局和不良事件。根据PD-L1表达和肝转移情况进行亚组分析。对于PD-L1高表达人群，与贝伐单抗相比，PD-1抑制剂加铂类双药方案可显著延长无进展生存期（PFS）。而对于PD-L1<50%的患者，含抗PD-1/PD-L1的治疗方案与贝伐单抗疗效相当。对于肝转移人群，存在抗PD-1加化疗带来PFS获益的趋势。对于PD-L1<50%的患者，化疗免疫治疗的优势缺乏充分证据。需要进行直接的头对头临床试验以确定特定患者的最佳治疗方案。
