Chen Wei, Liu Hangmei, Li Yiwen, Xue Wenxin, Fan Shuo, Sun Jingbo, Liu Shui, Liu Yang, Zhang Lili
Department of Pharmacy, Emergency General Hospital, Beijing, China.
Front Oncol. 2024 Apr 24;14:1365255. doi: 10.3389/fonc.2024.1365255. eCollection 2024.
The optimal first-line immunotherapy regimen for patients with PD-L1 expression ≥50% in squamous non-small cell lung cancer (Sq-NSCLC) remains uncertain. This study utilized net-work meta-analysis (NMA) to indirectly compare the efficacy of various first-line immuno-therapy regimens in this patient subset.
Systematic searches were conducted across PubMed, the Cochrane Library, Web of Science, and Embase databases for randomized controlled trials reporting overall survival (OS) and progression-free survival (PFS) outcomes. The search spanned from database inception to November 3, 2023. Bayesian network meta-analysis was employed for a comprehen-sive analysis. To ensure scientific rigor and transparency, this study is registered in the Interna-tional Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42022349712.
The NMA encompassed 9 randomized controlled trials (RCTs), involving 2170 patients and investigating 9 distinct immunotherapy regimens. For OS, the combination of camrelizumab and chemotherapy demonstrated the highest probability (36.68%) of efficacy, fol-lowed by cemiplimab (33.86%) and atezolizumab plus chemotherapy (23.87%). Regarding PFS, the camrelizumab and chemotherapy combination had the highest probability (39.70%) of efficacy, followed by pembrolizumab (22.88%) and pembrolizumab plus chemotherapy (17.69%). Compared to chemotherapy, first-line treatment with immune checkpoint inhibitors (ICIs) in Sq-NSCLC pa-tients exhibited significant improvements in OS (HR 0.59, 95% CI 0.47-0.75) and PFS (HR 0.44, 95% CI 0.37-0.52).
This study suggests that, for Sq-NSCLC patients with PD-L1 expression ≥50%, the first-line immunotherapy regimen of camrelizumab plus chemotherapy provides superior OS and PFS outcomes. Furthermore, ICIs demonstrate enhanced efficacy compared to chemotherapy in this patient population.
https://www.crd.york.ac.uk/prospero/, identifier: CRD 42022349712.
对于程序性死亡配体1（PD-L1）表达≥50%的鳞状非小细胞肺癌（Sq-NSCLC）患者，最佳一线免疫治疗方案仍不明确。本研究采用网络荟萃分析（NMA）间接比较该患者亚组中各种一线免疫治疗方案的疗效。
在PubMed、Cochrane图书馆、科学网和Embase数据库中进行系统检索，以查找报告总生存期（OS）和无进展生存期（PFS）结果的随机对照试验。检索范围从数据库建立至2023年11月3日。采用贝叶斯网络荟萃分析进行全面分析。为确保科学严谨性和透明度，本研究已在国际前瞻性系统评价注册库（PROSPERO）注册，注册号为CRD42022349712。
该NMA纳入了9项随机对照试验（RCT），涉及2170例患者，研究了9种不同的免疫治疗方案。对于OS，卡瑞利珠单抗联合化疗显示出最高的疗效概率（36.68%），其次是西米普利单抗（33.86%）和阿替利珠单抗联合化疗（23.87%）。关于PFS，卡瑞利珠单抗联合化疗的疗效概率最高（39.70%），其次是帕博利珠单抗（22.88%）和帕博利珠单抗联合化疗（17.69%）。与化疗相比，Sq-NSCLC患者一线使用免疫检查点抑制剂（ICI）治疗在OS（风险比[HR]0.59，95%置信区间[CI]0.47 - 0.75）和PFS（HR 0.44，95% CI 0.37 - 0.52）方面有显著改善。
本研究表明，对于PD-L1表达≥50%的Sq-NSCLC患者，卡瑞利珠单抗联合化疗的一线免疫治疗方案可提供更好的OS和PFS结果。此外，在该患者群体中，ICI与化疗相比疗效更佳。
https://www.crd.york.ac.uk/prospero/，标识符：CRD 42022349712。
