PMID- 32339922
OWN - NLM
STAT- MEDLINE
DCOM- 20210225
LR  - 20210225
IS  - 1878-1705 (Electronic)
IS  - 1567-5769 (Linking)
VI  - 84
DP  - 2020 Jul
TI  - Effectivity and safety of PD-1/PD-L1 inhibitors for different level of 
      PD-L1-positive, advanced NSCLC: A meta-analysis of 4939 patients from randomized 
      controlled trials.
PG  - 106452
LID - S1567-5769(20)30586-5 [pii]
LID - 10.1016/j.intimp.2020.106452 [doi]
AB  - BACKGROUND: Effective improvement for the programmed death 1 (PD-1)/programmed 
      death ligand 1 (PD-L1) inhibitors had been shown in advanced non-small cell lung 
      cancer (NSCLC) patients compared with traditional therapy. However, we do not 
      have ample evidences to demonstrate the safety and effectivity in the treatment 
      of PD-L1-positive, advanced NSCLC. The relation was controversial about the 
      expression of PD-L1 and survival outcomes of PD-1/PD-L1 inhibitors. MATERIALS AND 
      METHODS: Electronic databases (PubMed, EMBASE, and the Cochrane library) and 
      major conference proceedings were systematically searched for all clinical trials 
      in NSCLC using PD-1/PD-L1 inhibitors. Randomized controlled trials (RCTs) were 
      included to compare PD-1/PD-L1 inhibitors with chemotherapy in advanced NSCLC 
      patients reporting adverse events (AEs) and immune-related AEs (irAEs). The 
      incidence, Hazard Ratio (HR), Odds Ratio (OR), and corresponding 95% confidence 
      interval (CI) of outcomes were calculated. RESULTS: A total of 4939 patients from 
      10RCTs were included. In the group of PD-L1 >/= 1%, PD-L1 >/= 5%, PD-L1 >/= 10%, 
      PD-L1 >/= 50%, the HR of OS is 0.31(95%CI 0.38-0.23; p < 0.0001), 0.47(95%CI 
      0.82-0.12; p = 0.008), 0.85(95%CI 1.17-0.53; p < 0.0001), 0.47(95%CI 0.59-0.36; 
      p < 0.0001) respectively. The HR of PFS is 0.13(95%CI 0.01-0.24; p = 0.027), 
      0.31(95%CI 0.00-0.62; p < 0.0001), 0.62(95%CI 0.30-0.93; p < 0.0001), 0.40(95% CI 
      0.20-0.59; p < 0.0001) respectively. In terms of summary adverse events, 
      PD-1/PD-L1 inhibitors groups had a significant lower risks in any treat-realated 
      AEs than chemotherapy. About irAEs, PD-1/PD-L1 inhibitors groups had a 
      significant higher risks in irAEs than chemotherapy. CONCLUSION: PD-1/PD-L1 
      inhibitors are generally effected and safer than chemotherapy for patients with 
      PD-L1-positive, advanced NSCLC. However, PD-1/PD-L1 inhibitors can generate a 
      unique spectrum of irAEs, and even life-threatening.
CI  - Copyright (c) 2020 Elsevier B.V. All rights reserved.
FAU - Shi, Yuanchao
AU  - Shi Y
AD  - The Lanzhou University, The First Clinical Academy of Lanzhou University, Lanzhou 
      730000, Gansu, China.
FAU - Duan, Jingwei
AU  - Duan J
AD  - The Lanzhou University, The First Clinical Academy of Lanzhou University, Lanzhou 
      730000, Gansu, China.
FAU - Guan, Quanlin
AU  - Guan Q
AD  - Department of Surgical Oncology, The Lanzhou University First Hospital, Lanzhou 
      730000, Gansu, China. Electronic address: guanquanlin@163.com.
FAU - Xue, Penglong
AU  - Xue P
AD  - Department of Oncology, The Xi an Ninth Hospital, Xi an 710000, Shanxi, China.
FAU - Zheng, Ya
AU  - Zheng Y
AD  - Department of Gastroenterology, The Lanzhou University First Hospital, Lanzhou 
      730000, Gansu, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20200424
PL  - Netherlands
TA  - Int Immunopharmacol
JT  - International immunopharmacology
JID - 100965259
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antineoplastic Agents, Immunological)
RN  - 0 (B7-H1 Antigen)
RN  - 0 (Immune Checkpoint Inhibitors)
RN  - 0 (Programmed Cell Death 1 Receptor)
SB  - IM
MH  - Antibodies, Monoclonal/adverse effects/therapeutic use
MH  - Antineoplastic Agents, Immunological/*adverse effects/therapeutic use
MH  - B7-H1 Antigen/*antagonists & inhibitors/metabolism
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/immunology
MH  - Humans
MH  - Immune Checkpoint Inhibitors/*adverse effects/therapeutic use
MH  - Immunity/*drug effects
MH  - Lung Neoplasms/*drug therapy/immunology
MH  - Middle Aged
MH  - Programmed Cell Death 1 Receptor/*antagonists & inhibitors
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - Chemotherapy
OT  - Expression of PD-L1
OT  - Non-Small-Lung-cancer
OT  - Programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors
EDAT- 2020/04/28 06:00
MHDA- 2021/02/26 06:00
CRDT- 2020/04/28 06:00
PHST- 2020/03/01 00:00 [received]
PHST- 2020/03/26 00:00 [revised]
PHST- 2020/03/26 00:00 [accepted]
PHST- 2020/04/28 06:00 [pubmed]
PHST- 2021/02/26 06:00 [medline]
PHST- 2020/04/28 06:00 [entrez]
AID - S1567-5769(20)30586-5 [pii]
AID - 10.1016/j.intimp.2020.106452 [doi]
PST - ppublish
SO  - Int Immunopharmacol. 2020 Jul;84:106452. doi: 10.1016/j.intimp.2020.106452. Epub 
      2020 Apr 24.