PMID- 27583876
OWN - NLM
STAT- MEDLINE
DCOM- 20170208
LR  - 20220317
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 95
IP  - 35
DP  - 2016 Aug
TI  - Anti-PD-1/PD-L1 antibody therapy for pretreated advanced nonsmall-cell lung 
      cancer: A meta-analysis of randomized clinical trials.
PG  - e4611
LID - 10.1097/MD.0000000000004611 [doi]
LID - e4611
AB  - BACKGROUND: Anti-PD-1/PD-L1 antibody therapy is a promising clinical treatment 
      for nonsmall-cell lung cancer (NSCLC). However, whether anti-PD-1/PD-L1 antibody 
      therapy can provide added benefits for heavily pretreated patients with advanced 
      NSCLC and whether the efficacy of anti-PD-1/PD-L1 antibody therapy relates to the 
      tumor PD-L1 expression level remain controversial. Thus, this meta-analysis 
      evaluated the efficacy and safety of anti-PD-1/PD-L1 antibody therapy for 
      pretreated patients with advanced NSCLC. METHODS: Randomized clinical trials were 
      retrieved by searching the PubMed, EMBASE, ASCO meeting abstract, 
      clinicaltrial.gov, and Cochrane library databases. The pooled hazard ratios (HRs) 
      for overall survival (OS) and progression-free survival (PFS), and odds ratios 
      for the overall response rate and adverse events (AEs) were calculated by STATA 
      software. RESULTS: Three randomized clinical trials involving 1141 pretreated 
      patients with advanced NSCLC were included. These trials all compared the 
      efficacy and safety of anti-PD-1/PD-L1 antibodies (nivolumab and MPDL3280A) with 
      docetaxel. The results suggested that, for all patients, anti-PD-1/PD-L1 therapy 
      could acquire a greater overall response (odds ratio = 1.50, 95% CI: 1.08-2.07, 
      P = 0.015, P for heterogeneity [Ph] = 0.620) and longer OS (HR = 0.71, 95% CI: 
      0.61-0.81, P < 0.001, Ph = 0.361) than docetaxel, but not PFS (HR = 0.83, 95% CI: 
      0.65-1.06, P = 0.134; Ph = 0.031). Subgroup analyses according to the tumor PD-L1 
      expression level showed that anti-PD-1/PD-L1 therapy could significantly improve 
      both OS and PFS in patients with high expressions of PD-L1, but not in those with 
      low expressions. Generally, the rates of grade 3 or 4 AEs of anti-PD-1/PD-L1 
      therapy were significantly lower than that of docetaxel. However, the risks of 
      pneumonitis and hypothyroidism were significantly higher. CONCLUSION: 
      Anti-PD-1/PD-L1 antibody therapy may significantly improve the outcomes for 
      pretreated advanced NSCLC patients, with a better safety profile than docetaxel.
FAU - Zhou, Guo-Wu
AU  - Zhou GW
AD  - Department of Respiratory and Critical Care Medicine, Changhai Hospital, Second 
      Military Medical University Department of Pulmonary Medicine, Medicine, 85 
      Hospital of People's Liberation Army, Shanghai Department of Oncology, The First 
      Affiliated Hospital to PLA General Hospital, Beijing, P.R. China.
FAU - Xiong, Ye
AU  - Xiong Y
FAU - Chen, Si
AU  - Chen S
FAU - Xia, Fan
AU  - Xia F
FAU - Li, Qiang
AU  - Li Q
FAU - Hu, Jia
AU  - Hu J
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (B7-H1 Antigen)
RN  - 0 (CD274 protein, human)
RN  - 0 (PDCD1 protein, human)
RN  - 0 (Programmed Cell Death 1 Receptor)
RN  - 0 (Taxoids)
RN  - 15H5577CQD (Docetaxel)
RN  - 31YO63LBSN (Nivolumab)
RN  - 52CMI0WC3Y (atezolizumab)
SB  - IM
MH  - Antibodies, Monoclonal/administration & dosage/adverse effects
MH  - Antibodies, Monoclonal, Humanized
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - B7-H1 Antigen/*analysis
MH  - Carcinoma, Non-Small-Cell Lung/chemistry/*drug therapy
MH  - Disease-Free Survival
MH  - Docetaxel
MH  - Humans
MH  - Lung Neoplasms/chemistry/*drug therapy
MH  - Nivolumab
MH  - Programmed Cell Death 1 Receptor/*analysis
MH  - Randomized Controlled Trials as Topic
MH  - Retreatment
MH  - Survival Rate
MH  - Taxoids/administration & dosage
PMC - PMC5008560
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2016/09/02 06:00
MHDA- 2017/02/09 06:00
PMCR- 2016/09/02
CRDT- 2016/09/02 06:00
PHST- 2016/09/02 06:00 [entrez]
PHST- 2016/09/02 06:00 [pubmed]
PHST- 2017/02/09 06:00 [medline]
PHST- 2016/09/02 00:00 [pmc-release]
AID - 00005792-201608300-00036 [pii]
AID - 10.1097/MD.0000000000004611 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2016 Aug;95(35):e4611. doi: 10.1097/MD.0000000000004611.