PMID- 33586297
OWN - NLM
STAT- MEDLINE
DCOM- 20211119
LR  - 20220527
IS  - 1759-7714 (Electronic)
IS  - 1759-7706 (Print)
IS  - 1759-7706 (Linking)
VI  - 12
IP  - 7
DP  - 2021 Apr
TI  - Anti-PD1 versus anti-PD-L1 immunotherapy in first-line therapy for advanced 
      non-small cell lung cancer: A systematic review and meta-analysis.
PG  - 1058-1066
LID - 10.1111/1759-7714.13867 [doi]
AB  - BACKGROUND: Due to the increasing number of trials with immune checkpoint 
      inhibitors (ICIs) in the first-line therapy of non-small cell lung cancer (NSCLC) 
      patients, we performed a systematic review and meta-analyses to investigate the 
      difference between anti PD-1 and PD-L1 antibodies, used alone or in combination 
      with chemotherapy, through adjusted indirect analysis to minimize the potential 
      bias regarding overall survival (OS), progression-free survival (PFS), overall 
      response rate (ORR) and grade 3-5 adverse events (AEs). METHODS: A systematic 
      review of studies reporting clinical outcomes and toxicity associated with 
      first-line therapy employing anti-PD1 or anti-PD-L1 antibodies alone, or in 
      combination with chemotherapy, to treat metastatic, treatment-naive NSCLC 
      patients was performed. Primary outcomes were OS, PFS, ORR and grade 3-5 AEs. We 
      used a random-effects model to generate pooled estimates for proportions. 
      Meta-analyses using pooled risk ratios were performed for binary outcomes from 
      comparative studies with the random effects model. RESULTS: A total of 13 
      eligible studies met our eligibility criteria, including 7673 patients. In the 
      ICI-chemotherapy combination subgroup, we observed that anti-PD1 therapy was 
      associated with better OS (p = 0.022) and PFS (p = 0.029) compared with 
      anti-PD-L1 therapy. In the monotherapy subgroup, there was no statistical 
      difference between the use of anti-PD-1 and anti-PD-L1 for OS and PFS. With 
      regard to ORR and toxicity, in the ICI-chemotherapy combination subgroup, we 
      observed a trend of better ORR (p = 0.12) with the use of anti-PD1 therapy and 
      less frequent grade 3-5 AEs compared to the use of anti-PD-L1 therapy (p = 
      0.0302). In the monotherapy subgroup, there was no statistical difference between 
      the use of anti-PD-1 and anti-PD-L1 regarding ORR and toxicity. CONCLUSIONS: Our 
      study suggests that PD-1 drug plus chemotherapy is superior to anti-PD-L1 plus 
      chemotherapy for NSCLC; nevertheless, as monotherapy, both strategies appear to 
      be similar.
CI  - (c) 2021 The Authors. Thoracic Cancer published by China Lung Oncology Group and 
      John Wiley & Sons Australia, Ltd.
FAU - Brito, Angelo Borsarelli Carvalho
AU  - Brito ABC
AUID- ORCID: 0000-0001-9424-0010
AD  - Department of Medical Oncology, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
FAU - Camandaroba, Marcos Pedro Guedes
AU  - Camandaroba MPG
AD  - Department of Medical Oncology, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
FAU - de Lima, Vladmir Claudio Cordeiro
AU  - de Lima VCC
AD  - Department of Medical Oncology, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20210214
PL  - Singapore
TA  - Thorac Cancer
JT  - Thoracic cancer
JID - 101531441
RN  - 0 (Immune Checkpoint Inhibitors)
SB  - IM
CIN - Thorac Cancer. 2022 Apr;13(7):1104-1105. PMID: 35199960
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/mortality/pathology
MH  - Humans
MH  - Immune Checkpoint Inhibitors/pharmacology/*therapeutic use
MH  - Immunotherapy/*methods
MH  - Lung Neoplasms/*drug therapy/mortality/pathology
MH  - Progression-Free Survival
MH  - Treatment Outcome
PMC - PMC8017262
OTO - NOTNLM
OT  - NSCLC
OT  - anti-PD-L1
OT  - anti-PD1
OT  - immunotherapy
OT  - meta-analysis
COIS- The authors confirm that there are no conflicts of interest.
EDAT- 2021/02/16 06:00
MHDA- 2021/11/20 06:00
PMCR- 2021/04/01
CRDT- 2021/02/15 06:18
PHST- 2021/01/12 00:00 [revised]
PHST- 2020/11/22 00:00 [received]
PHST- 2021/01/12 00:00 [accepted]
PHST- 2021/02/16 06:00 [pubmed]
PHST- 2021/11/20 06:00 [medline]
PHST- 2021/02/15 06:18 [entrez]
PHST- 2021/04/01 00:00 [pmc-release]
AID - TCA13867 [pii]
AID - 10.1111/1759-7714.13867 [doi]
PST - ppublish
SO  - Thorac Cancer. 2021 Apr;12(7):1058-1066. doi: 10.1111/1759-7714.13867. Epub 2021 
      Feb 14.