PMID- 30577837
OWN - NLM
STAT- MEDLINE
DCOM- 20191014
LR  - 20240413
IS  - 2051-1426 (Electronic)
IS  - 2051-1426 (Linking)
VI  - 6
IP  - 1
DP  - 2018 Dec 22
TI  - Immune-checkpoint inhibitor plus chemotherapy versus conventional chemotherapy 
      for first-line treatment in advanced non-small cell lung carcinoma: a systematic 
      review and meta-analysis.
PG  - 155
LID - 10.1186/s40425-018-0477-9 [doi]
LID - 155
AB  - BACKGROUND: Immune-checkpoint inhibitors plus chemotherapy are emerging as 
      effective first-line treatment in advanced non-small-cell lung carcinoma (NSCLC), 
      but little is known about the magnitude of benefits and potential clinical 
      predictors. METHODS: We performed a meta-analysis of randomized trials that 
      compared PD-1/PD-L1 inhibitor plus chemotherapy with chemotherapy in first line 
      of treatment for advanced NSCLC. The outcomes included progression-free survival 
      (PFS), overall survival (OS), objective response rate (ORR) and treatment-related 
      adverse events (AEs). A fixed-effect or random-effects model was adopted 
      depending on between-study heterogeneity. RESULTS: Six trials involving 3144 
      patients were included. PD-1/PD-L1 inhibitor plus chemotherapy was significantly 
      associated with improvement of PFS (hazards ratio [HR], 0.62; 95% CI 0.57-0.67; 
      P < .001), OS (HR, 0.68; 95% CI 0.53-0.87; P = .002) and ORR (relative ratio 
      [RR], 1.56; 95% CI 1.29-1.89; P < .001), irrespective of PD-L1 expression level. 
      The significant predictor(s) for treatment benefit with combination therapy 
      versus chemotherapy alone were PD-L1 expression level for PFS (P < .001); types 
      of checkpoint inhibitor for ORR (P < .001); histology (P = .025), age (P = .038), 
      gender (P < .001), and types of checkpoint inhibitor (P < .001) for OS. In safety 
      analyses, PD-1/PD-L1 inhibitor plus chemotherapy had significantly higher 
      incidence of adverse events (AEs) of grade 3 or higher (RR, 1.14; P = .007), AEs 
      leading to treatment discontinuation (RR, 1.29; P = .022), serious AEs (RR 1.70; 
      P = .006), immune mediated AEs of any grade (RR, 2.37; P < .001), and immune 
      mediated AEs of grade 3 or higher (RR, 3.71; P < .001). CONCLUSIONS: PD-1/PD-L1 
      inhibitor plus chemotherapy, compared with chemotherapy, is associated with 
      significantly improved PFS, ORR, and OS in first-line therapy in NSCLC, at the 
      expense of increased treatment-related AEs.
FAU - Zhou, Yixin
AU  - Zhou Y
AD  - State Key Laboratory of Oncology in South China, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
AD  - Department of VIP region, Sun Yat-sen University Cancer Center, Guangzhou, China.
FAU - Chen, Chen
AU  - Chen C
AD  - State Key Laboratory of Oncology in South China, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
AD  - Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, 
      China.
FAU - Zhang, Xuanye
AU  - Zhang X
AD  - State Key Laboratory of Oncology in South China, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
AD  - Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 
      Dongfeng East Road, Guangzhou, 510060, China.
FAU - Fu, Sha
AU  - Fu S
AD  - Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene 
      Regulation, Pathology Department, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen 
      University, Guangzhou, China.
FAU - Xue, Cong
AU  - Xue C
AD  - State Key Laboratory of Oncology in South China, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
AD  - Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 
      Dongfeng East Road, Guangzhou, 510060, China.
FAU - Ma, Yuxiang
AU  - Ma Y
AD  - State Key Laboratory of Oncology in South China, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
AD  - Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 
      Dongfeng East Road, Guangzhou, 510060, China.
FAU - Fang, Wenfeng
AU  - Fang W
AD  - State Key Laboratory of Oncology in South China, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
AD  - Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 
      Dongfeng East Road, Guangzhou, 510060, China.
FAU - Yang, Yunpeng
AU  - Yang Y
AD  - State Key Laboratory of Oncology in South China, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
AD  - Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 
      Dongfeng East Road, Guangzhou, 510060, China.
FAU - Hou, Xue
AU  - Hou X
AD  - State Key Laboratory of Oncology in South China, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
AD  - Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 
      Dongfeng East Road, Guangzhou, 510060, China.
FAU - Huang, Yan
AU  - Huang Y
AD  - State Key Laboratory of Oncology in South China, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
AD  - Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 
      Dongfeng East Road, Guangzhou, 510060, China.
FAU - Zhao, Hongyun
AU  - Zhao H
AD  - State Key Laboratory of Oncology in South China, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
AD  - Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 
      Dongfeng East Road, Guangzhou, 510060, China.
FAU - Hong, Shaodong
AU  - Hong S
AUID- ORCID: 0000-0002-5632-6857
AD  - State Key Laboratory of Oncology in South China, Guangzhou, China. 
      hongshd@sysucc.org.cn.
AD  - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. 
      hongshd@sysucc.org.cn.
AD  - Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 
      Dongfeng East Road, Guangzhou, 510060, China. hongshd@sysucc.org.cn.
FAU - Zhang, Li
AU  - Zhang L
AD  - State Key Laboratory of Oncology in South China, Guangzhou, China. 
      zhangli6@mail.sysu.edu.cn.
AD  - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. 
      zhangli6@mail.sysu.edu.cn.
AD  - Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 
      Dongfeng East Road, Guangzhou, 510060, China. zhangli6@mail.sysu.edu.cn.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20181222
PL  - England
TA  - J Immunother Cancer
JT  - Journal for immunotherapy of cancer
JID - 101620585
RN  - 0 (Antineoplastic Agents, Immunological)
RN  - 0 (B7-H1 Antigen)
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (CD274 protein, human)
RN  - 0 (Programmed Cell Death 1 Receptor)
SB  - IM
MH  - Antineoplastic Agents, Immunological/administration & dosage/*therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - B7-H1 Antigen/antagonists & inhibitors
MH  - Biomarkers, Tumor
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/immunology/metabolism/pathology
MH  - Clinical Trials as Topic
MH  - Humans
MH  - Lung Neoplasms/*drug therapy/immunology/metabolism/pathology
MH  - *Molecular Targeted Therapy
MH  - Programmed Cell Death 1 Receptor/antagonists & inhibitors
MH  - Treatment Outcome
PMC - PMC6303974
OTO - NOTNLM
OT  - Chemotherapy
OT  - Immune checkpoint inhibitor
OT  - Non-small cell lung carcinoma
OT  - Predict
OT  - Programmed death 1
OT  - Programmed death 1 ligand 1
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Not applicable. CONSENT FOR 
      PUBLICATION: Not applicable. COMPETING INTERESTS: Li Zhang has received research 
      support from AstraZeneca, Eli Lilly and company, and Roche. No other disclosures 
      were reported. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to 
      jurisdictional claims in published maps and institutional affiliations.
EDAT- 2018/12/24 06:00
MHDA- 2019/10/15 06:00
PMCR- 2018/12/22
CRDT- 2018/12/23 06:00
PHST- 2018/08/15 00:00 [received]
PHST- 2018/12/06 00:00 [accepted]
PHST- 2018/12/23 06:00 [entrez]
PHST- 2018/12/24 06:00 [pubmed]
PHST- 2019/10/15 06:00 [medline]
PHST- 2018/12/22 00:00 [pmc-release]
AID - 10.1186/s40425-018-0477-9 [pii]
AID - 477 [pii]
AID - 10.1186/s40425-018-0477-9 [doi]
PST - epublish
SO  - J Immunother Cancer. 2018 Dec 22;6(1):155. doi: 10.1186/s40425-018-0477-9.