Xu X, et al. - Researchers, in this meta-analysis, investigated the therapeutic efficacy and safety of anti-PD-1/PD-L1 antibodies combined with chemotherapy or CTLA4 antibody as first-line treatments for patients with advanced lung cancer. Observation revealed a synergistic activity and an acceptable safety profile with checkpoint inhibitor plus chemotherapy combination treatment in lung cancer.

Methods

• Researchers performed a systematic search in databases for this system review and quantitative meta-analysis.
• The meta-analysis finally included 12 trials.

Results

• The treatment of non-small cell lung cancer (NSCLC) with immune checkpoint inhibitors combined with chemotherapy resulted in the combined overall response rate (ORR) and disease control rate (DCR) of 47.0% (95% CI: 34.2% - 60.2%) and 80.9% (95% CI: 69.4% - 88.7%), respectively.
• For CTLA4 antibody combined with chemotherapy for the treatment of small-cell lung cancer (SCLC), the combined ORR and DCR were 65.4% (61.1%-69.5%) and 87.6% (84.5%-90.2%), respectively.
• For NSCLC and SCLC, the combined six-month progression-free survival rates (PFSRs_6m) were 50.2% (95% CI: 21.9% - 78.4%) and 30.7% (21.2%-40.3%), respectively, and the OSRs_1y were 56.4% (39.1%-73.7%) and 36.9% (33.3%-40.5%), respectively.
• Moreover, for the checkpoint inhibitors plus CTLA4 antibody treatment group in NSCLC, the combined ORR and DCR were 29.6% (95% CI: 11.4%-57.8%) and 48.7% (16.8%-81.7%), respectively.
• Subgroup analyses revealed a significant enhancement in PFS in NSCLC and SCLC, with a combined hazard ratio and 95% confidence interval of 0.841 (0.737-0.961) and 0.856 (0.756-0.968), respectively.