PMID- 34297160
OWN - NLM
STAT- MEDLINE
DCOM- 20220228
LR  - 20240426
IS  - 1432-0851 (Electronic)
IS  - 0340-7004 (Print)
IS  - 0340-7004 (Linking)
VI  - 71
IP  - 3
DP  - 2022 Mar
TI  - Efficacy and safety of PD-L1 inhibitors versus PD-1 inhibitors in first-line 
      treatment with chemotherapy for extensive-stage small-cell lung cancer.
PG  - 637-644
LID - 10.1007/s00262-021-03017-z [doi]
AB  - OBJECTIVES: Programmed cell death-ligand 1 inhibitors plus chemotherapy 
      (PD-L1 + Chemo) have achieved substantial progress in extensive-stage small-cell 
      lung cancer (ES-SCLC). However, evidence about programmed cell death 1 inhibitors 
      plus chemotherapy (PD-1 + Chemo) in SCLC is relatively lacking. Whether PD-1 
      inhibitors differ from PD-L1 inhibitors in their clinical outcomes remains 
      controversial. MATERIALS AND METHODS: We performed a meta-analysis to compare 
      efficacy and safety of PD-L1 + Chemo vs PD-1 + Chemo in ES-SCLC by searching 
      PubMed, Embase, the Cochrane Library, and major oncology conferences. We examined 
      overall survival (OS) as the primary outcome. Secondary outcomes included 
      progression-free survival (PFS), objective response rate (ORR), and 
      treatment-related adverse events (AEs). RESULTS: We included four randomized 
      trials (IMpower133, CASPIAN, KEYNOTE-604, and EA5161) with a total of 1553 
      patients. Direct comparison showed that PD-L1 + Chemo (PFS: hazard ratio [HR] 
      0.79; OS: HR 0.75) and PD-1 + Chemo (PFS: HR 0.72; OS: HR 0.77) significantly 
      prolonged survival time compared with chemotherapy alone. But PD-L1 + Chemo 
      (relative risk [RR]: 1.07) and PD-1 + Chemo (RR: 1.13) were not superior to 
      chemotherapy alone in terms of ORR. Indirect comparison showed no significant 
      difference in clinical efficacy between PD-L1 + Chemo and PD-1 + Chemo (OS: HR 
      0.99; PFS: HR 1.10; ORR: RR 0.95). We further stratified patients according to 
      subgroups in terms of OS. In the subgroup of patients with brain metastasis, 
      PD-L1 + Chemo tended to prolong OS (HR: 0.61, 0.28 to 1.32). There were no 
      significant differences between PD-L1 + Chemo and PD-1 + Chemo regarding safety 
      analyses. However, PD-L1 + Chemo exhibited a better safety profile in reducing 
      the risk of treatment discontinuation due to AEs (RR: 0.43, 0.19 to 0.95) and 
      pneumonia (pneumonia of any grade, RR: 0.59, 0.24 to 1.42; pneumonia of 
      grade >/= 3, RR: 0.37, 0.10 to 1.39). CONCLUSIONS: PD-L1 + Chemo and PD-1 + Chemo 
      provided a significant survival benefit relative to chemotherapy alone for 
      ES-SCLC. The efficacy and safety of PD-L1 + Chemo and PD-1 + Chemo were similar 
      based on current evidence.
CI  - (c) 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Yu, Hui
AU  - Yu H
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, 651 Dongfeng East 
      Road, Guangzhou, 510060, China.
FAU - Chen, Ping
AU  - Chen P
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, 651 Dongfeng East 
      Road, Guangzhou, 510060, China.
FAU - Cai, Xiuyu
AU  - Cai X
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, 651 Dongfeng East 
      Road, Guangzhou, 510060, 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 - He, Lina
AU  - He L
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 - Zhou, Yixin
AU  - Zhou Y
AD  - State Key Laboratory of Oncology in South China, Guangzhou, China. 
      zhouyx@sysucc.org.cn.
AD  - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. 
      zhouyx@sysucc.org.cn.
AD  - Department of VIP Region, Sun Yat-Sen University Cancer Center, 651 Dongfeng East 
      Road, Guangzhou, 510060, China. zhouyx@sysucc.org.cn.
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, Bei
AU  - Zhang B
AD  - State Key Laboratory of Oncology in South China, Guangzhou, China. 
      zhangbei@sysucc.org.cn.
AD  - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. 
      zhangbei@sysucc.org.cn.
AD  - Department of VIP Region, Sun Yat-Sen University Cancer Center, 651 Dongfeng East 
      Road, Guangzhou, 510060, China. zhangbei@sysucc.org.cn.
LA  - eng
GR  - 81903176/National Natural Science Funds of China/
GR  - 2019A1515011596/Science and Technology Program of Guangdong Province/
GR  - C2019110/Medical Scientific Research Foundation of Guangdong Province/
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20210723
PL  - Germany
TA  - Cancer Immunol Immunother
JT  - Cancer immunology, immunotherapy : CII
JID - 8605732
RN  - 0 (B7-H1 Antigen)
RN  - 0 (CD274 protein, human)
RN  - 0 (Immune Checkpoint Inhibitors)
RN  - 0 (PDCD1 protein, human)
RN  - 0 (Programmed Cell Death 1 Receptor)
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - B7-H1 Antigen/*antagonists & inhibitors
MH  - Disease Management
MH  - Disease Susceptibility
MH  - Humans
MH  - Immune Checkpoint Inhibitors/administration & dosage
MH  - Lung Neoplasms/diagnosis/*drug therapy/etiology/metabolism
MH  - Molecular Targeted Therapy
MH  - Neoplasm Metastasis
MH  - Neoplasm Staging
MH  - Odds Ratio
MH  - Prognosis
MH  - Programmed Cell Death 1 Receptor/*antagonists & inhibitors
MH  - Small Cell Lung Carcinoma/*drug therapy/etiology/metabolism/*pathology
MH  - Treatment Outcome
PMC - PMC10992902
OTO - NOTNLM
OT  - Efficacy
OT  - First-line therapy
OT  - PD-1 inhibitors
OT  - PD-L1 inhibitors
OT  - Small-cell lung cancer
COIS- The authors declare that they have no competing interests.
EDAT- 2021/07/24 06:00
MHDA- 2022/03/01 06:00
PMCR- 2021/07/23
CRDT- 2021/07/23 12:25
PHST- 2021/02/25 00:00 [received]
PHST- 2021/07/11 00:00 [accepted]
PHST- 2021/07/24 06:00 [pubmed]
PHST- 2022/03/01 06:00 [medline]
PHST- 2021/07/23 12:25 [entrez]
PHST- 2021/07/23 00:00 [pmc-release]
AID - 10.1007/s00262-021-03017-z [pii]
AID - 3017 [pii]
AID - 10.1007/s00262-021-03017-z [doi]
PST - ppublish
SO  - Cancer Immunol Immunother. 2022 Mar;71(3):637-644. doi: 
      10.1007/s00262-021-03017-z. Epub 2021 Jul 23.