PMID- 32900864
OWN - NLM
STAT- MEDLINE
DCOM- 20211014
LR  - 20211014
IS  - 2051-1426 (Electronic)
IS  - 2051-1426 (Linking)
VI  - 8
IP  - 2
DP  - 2020 Sep
TI  - Immune-checkpoint inhibitors plus chemotherapy versus chemotherapy as first-line 
      treatment for patients with extensive-stage small cell lung cancer.
LID - 10.1136/jitc-2020-001300 [doi]
LID - e001300
AB  - We performed a meta-analysis to comprehensively investigate the efficacy and 
      safety of immune-checkpoint inhibitors (ICIs) plus chemotherapy in patients with 
      extensive-stage small cell lung cancer (ES-SCLC). The primary outcome was overall 
      survival (OS). The secondary outcomes included progression-free survival (PFS), 
      objective response rate (ORR) and >/=grade 3 adverse events (AEs). A total of six 
      studies involving 2905 patients were identified, including 469 patients receiving 
      program death ligand 1 (PD-L1) inhibitor plus chemotherapy, 308 receiving PD-1 
      inhibitors plus chemotherapy, 563 receiving CTLA-4 inhibitors plus chemotherapy, 
      268 receiving PD-L1/CTLA-4 inhibitors plus chemotherapy, and 1297 receiving 
      chemotherapy alone. 10.8% (283/2615) patients had baseline brain metastases 
      (BMs). Notably, ICIs plus chemotherapy was associated with significantly improved 
      OS (HR, 0.82; 95% CI, 0.75 to 0.89). Subgroup analyses revealed that PD-1 
      inhibitors (HR, 0.77; 95% CI, 0.64 to 0.92) and PD-L1 inhibitors (HR, 0.73; 95% 
      CI, 0.63 to 0.85) plus chemotherapy yielded a statistically significant 
      improvement in OS while CTLA-4 inhibitors did not (HR, 0.92; 95% CI, 0.81 to 
      1.06). In patients with baseline BMs, ICIs plus chemotherapy showed no survival 
      benefits over chemotherapy alone (HR, 1.23; 95% CI, 0.92 to 1.64). ICIs plus 
      chemotherapy also significantly prolonged PFS (HR, 0.81; 95% CI, 0.75 to 0.87) 
      while the pooled ORRs were comparable between ICIs plus chemotherapy and 
      chemotherapy alone (RR, 1.04; 95% CI, 0.99 to 1.10). Patients treated with CTLA-4 
      inhibitors (relative risk (RR), 1.12; 95% CI, 0.99 to 1.28) experienced 
      more>/=grade 3 AEs than those treated with PD-1/PD-L1 inhibitors (RR, 1.03; 95% CI, 
      0.96 to 1.11). The addition of PD-1/PD-L1 inhibitors to chemotherapy resulted in 
      significant improvements in both PFS and OS for patients with treatment-naive 
      ES-SCLC, not at the cost of increased AEs.
CI  - (c) Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Zhou, Fei
AU  - Zhou F
AD  - Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer 
      Institute, Tongji University School of Medicine, Shanghai, China.
FAU - Zhao, Wencheng
AU  - Zhao W
AD  - Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer 
      Institute, Tongji University School of Medicine, Shanghai, China.
FAU - Gong, Xiaomei
AU  - Gong X
AD  - Department of Radiation Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer 
      Institute, Tongji University School of Medicine, Shanghai, China.
FAU - Ren, Shengxiang
AU  - Ren S
AD  - Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer 
      Institute, Tongji University School of Medicine, Shanghai, China.
FAU - Su, Chunxia
AU  - Su C
AD  - Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer 
      Institute, Tongji University School of Medicine, Shanghai, China.
FAU - Jiang, Tao
AU  - Jiang T
AD  - Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, 
      Zhongshan Hospital, Fudan University, Shanghai, China caicunzhou_dr@163.com 
      tonyjiangdr@163.com.
FAU - Zhou, Caicun
AU  - Zhou C
AD  - Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer 
      Institute, Tongji University School of Medicine, Shanghai, China 
      caicunzhou_dr@163.com tonyjiangdr@163.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - J Immunother Cancer
JT  - Journal for immunotherapy of cancer
JID - 101620585
RN  - 0 (Immune Checkpoint Inhibitors)
SB  - IM
MH  - Humans
MH  - Immune Checkpoint Inhibitors/pharmacology/*therapeutic use
MH  - Immunotherapy/*methods
MH  - Lung Neoplasms/*drug therapy
MH  - Neoplasm Staging
MH  - Small Cell Lung Carcinoma/*drug therapy
PMC - PMC7477983
OTO - NOTNLM
OT  - lung neoplasms
COIS- Competing interests: None declared.
EDAT- 2020/09/10 06:00
MHDA- 2021/10/15 06:00
PMCR- 2020/09/07
CRDT- 2020/09/09 05:25
PHST- 2020/08/14 00:00 [accepted]
PHST- 2020/09/09 05:25 [entrez]
PHST- 2020/09/10 06:00 [pubmed]
PHST- 2021/10/15 06:00 [medline]
PHST- 2020/09/07 00:00 [pmc-release]
AID - jitc-2020-001300 [pii]
AID - 10.1136/jitc-2020-001300 [doi]
PST - ppublish
SO  - J Immunother Cancer. 2020 Sep;8(2):e001300. doi: 10.1136/jitc-2020-001300.