de Moraes Francisco Cezar Aquino, Pasqualotto Eric, de Oliveira Rodrigues Anna Luíza Soares, Burbano Rommel Mario Rodríguez
Federal University of Pará, Belém, Pará, 66073-005, Brazil.
Federal University of Santa Catarina, Florianópolis, Santa Catarina, 88040-900, Brazil.
Eur J Clin Pharmacol. 2025 Jan;81(1):139-150. doi: 10.1007/s00228-024-03777-4. Epub 2024 Nov 14.
The optimal treatment for resectable Non-Small Cell Lung Cancer (NSCLC) remains under investigation, particularly about its effectiveness across different ethnicities. This meta-analysis aims to investigate the potential benefits of adding PD1/PD-L1 inhibitors for treatment, stratified by ethnicity.
We searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) that investigated the use of PD1/PD-L1 inhibitors to treat patients with resectable NSCLC. The outcomes evaluated were disease-free survival/event-free survival (DFS/EFS), major pathological response (MPR), and pathological complete response (pCR). Hazard ratios (HRs) or risk ratios (RRs) with 95% confidence intervals (CIs) were computed for all endpoints using DerSimonian and Laird random-effects models. Statistical analyses were performed with R Software, version 4.2.3.
A total of six RCTs comprising 3,827 patients with NSCLC were included. In populations of Asian descent, PD1/PD-L1 significantly improved DFS/EFS (HR 0.59; 95% CI 0.44-0.78), MPR (RR 5.76; 95% CI 3.58-9.28), and pCR (RR 25.00; 95% CI 6.17-101.36). Similarly, patients of European ancestry experienced significantly improved DFS/EFS (HR 0.77; 95% CI 0.65-0.90), MPR (RR 2.75; 95% CI 2.00-3.77), and pCR (RR 4.53; 95% CI 2.69-7.6) with PD1/PD-L1 therapy. Notably, patients with mixed ethnicity also demonstrated significant improvement in MPR (RR 4.05; 95% CI 2.60-6.33) and pCR (RR 8.44; 95% CI 3.75-19.00) when receiving PD1/PD-L1 inhibitors.
This comprehensive meta-analysis suggests that incorporating PD1/PD-L1 inhibitors into treatments offers a promising benefit for patients with resectable NSCLC, regardless of ethnicity. Future studies with in-depth molecular characterization of patients can further refine these findings and potentially guide the development of personalized treatment strategies based on individual ethnic backgrounds.
可切除非小细胞肺癌（NSCLC）的最佳治疗方案仍在研究中，尤其是其在不同种族中的有效性。本荟萃分析旨在研究添加PD1/PD-L1抑制剂进行治疗的潜在益处，并按种族进行分层。
我们在PubMed、Embase和Cochrane数据库中检索了调查使用PD1/PD-L1抑制剂治疗可切除NSCLC患者的随机对照试验（RCT）。评估的结局指标为无病生存期/无事件生存期（DFS/EFS）、主要病理缓解（MPR）和病理完全缓解（pCR）。使用DerSimonian和Laird随机效应模型计算所有终点的风险比（HRs）或比值比（RRs）及95%置信区间（CIs）。使用R软件4.2.3版进行统计分析。
共纳入6项RCT，涉及3827例NSCLC患者。在亚裔人群中，PD1/PD-L1显著改善了DFS/EFS（HR 0.59；95% CI 0.44 - 0.78）、MPR（RR 5.76；95% CI 3.58 - 9.28）和pCR（RR 25.00；95% CI 6.17 - 101.36）。同样，欧洲血统的患者接受PD1/PD-L1治疗后，DFS/EFS（HR 0.77；95% CI
0.65 - 0.90）、MPR（RR 2.75；95% CI 2.00 - 3.77）和pCR（RR 4.53；95% CI 2.69 - 7.6）也有显著改善。值得注意的是，混合种族的患者在接受PD接受PD1/PD-L1抑制剂治疗时，MPR（RR 4.05；95% CI 2.60 - 6.33）和pCR（RR 8.44；95% CI 3.75 - 19.00）也有显著改善。
这项全面的荟萃分析表明，将PD1/PD-L1抑制剂纳入治疗方案对可切除NSCLC患者具有显著益处，无论其种族如何。未来对患者进行深入分子特征分析的研究可以进一步完善这些发现，并有可能指导基于个体种族背景的个性化治疗策略的制定。
