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Comparative efficacy of chemoimmunotherapy vs immunotherapy for advanced non–small cell lung cancer: A network meta‐analysis of randomized trials

Cancer Nov 04, 2020

Pathak R, De Lima Lopes G, Yu H, et al. - In the first‐line treatment of patients with advanced non–small cell lung cancer (NSCLC), researchers sought to compare the efficacy of chemoimmunotherapy vs ICIs via a systematic literature review and network meta‐analysis. They searched MEDLINE, Excerpta Medica dataBASE (EMBASE), Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from inception to April 2020 and identified a total of 12 eligible trials comprising 7,845 patients for inclusion. There was no statistically significant difference with regard to OS, PFS, or the ORR when comparing chemoimmunotherapy with dual‐agent ICI in patients who were negative for PD‐L1. With regard to OS or the ORR, there was no statistically significant difference seen between chemoimmunotherapy vs either single‐agent ICI or dual‐agent ICI in patients with low PD‐L1. Chemoimmunotherapy was associated with an improved PFS and ORR compared with single‐agent ICI, but not with dual‐agent ICI, in patients with high PD‐L1. No differences in OS were observed with chemoimmunotherapy when compared with either single‐agent or dual‐agent ICIs. In conclusion, despite a correlation of chemoimmunotherapy with improvement in the overall response rate and progression‐free survival in patients with PD‐L1–high tumors vs single‐agent ICI, it seemed not to confer an overall survival benefit over single‐agent or dual‐agent ICI for patients with advanced NSCLC regardless of PD‐L1 status.

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