PMID- 34477154
OWN - NLM
STAT- MEDLINE
DCOM- 20210910
LR  - 20231107
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 100
IP  - 35
DP  - 2021 Sep 3
TI  - Efficacy and safety of PD-1/PD-L1 inhibitors combined with CTLA-4 inhibitor 
      versus chemotherapy for advanced lung cancer: A meta-analysis.
PG  - e27121
LID - 10.1097/MD.0000000000027121 [doi]
LID - e27121
AB  - BACKGROUND: This meta-analysis was performed to compare efficacy and tolerability 
      between antiprogrammed cell death (PD-1)/programmed cell death-ligand-1 (PD-L1) + 
      anticytotoxic T-lymphocyte-associated protein-4 (CTLA-4) treatment and 
      chemotherapy in advanced lung cancer. METHODS: Cochrane Library, Embase, and 
      PubMed databases were searched for potential articles. The fixed-effect model or 
      random-effect model was adopted for pooled analysis based on the I2 and P-value. 
      RESULTS: Six articles with 1338 patients were identified and subjected to 
      meta-analysis. Compared with chemotherapy, anti-PD-1/PD-L1 + anti-CTLA-4 
      treatment could significantly improve the overall survival (hazard ratio 
      [HR] = 0.78, 95%confidence interval [CI]: 0.71-0.84, P = .21) and 
      progression-free survival (HR = 0.77, 95%CI: 0.71-0.83, P = .30) of advanced lung 
      cancer patients. Moreover, there was no obvious difference in the incidence of 3 
      to 4 adverse events (AEs) serious adverse reactions (HR = 1.35, 95%CI: 0.66-2.74, 
      P < .00001) between the 2 treatment groups, but the incidence rates of AEs 
      leading to discontinuation (HR = 2.56, 95%CI: 1.53-4.30, P < .00001) and AEs 
      leading to death (HR = 2.10, 95%CI: 1.21-3.63, P = .20) were higher. Furthermore, 
      no remarkable differences in objective response rate (HR = 1.31, 95%CI: 
      0.97-1.77, P = .02) were observed between the 2 groups. CONCLUSION: Our 
      meta-analysis revealed that PD-1/PD-L1 inhibitors plus CTLA-4 inhibitor could 
      markedly improve the endpoint outcomes of patients compared with chemotherapy 
      alone, and did not significantly increase the serious adverse reactions. Thus, it 
      can serve as a new treatment strategy for advanced lung cancer.
CI  - Copyright (c) 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Zhang, Pei-Pei
AU  - Zhang PP
AD  - Department of Oncology, Affiliated Hospital of Nantong University, Tongzhou 
      District People's Hospital, Nantong City, Jiangsu Province, No. 115, Jianshe 
      Road, Jinsha Town, Tongzhou District, Nantong City, Jiangsu Province, China.
FAU - Wang, Juan
AU  - Wang J
AD  - Department of Oncology, Affiliated Hospital of Nantong University, Tongzhou 
      District People's Hospital, Nantong City, Jiangsu Province, No. 115, Jianshe 
      Road, Jinsha Town, Tongzhou District, Nantong City, Jiangsu Province, China.
FAU - Ding, Da-Zhi
AU  - Ding DZ
AD  - Department of Orthopaedics, Affiliated Hospital of Nantong University, Tongzhou 
      District People's Hospital, Nantong City, Jiangsu Province, No. 115, Jianshe 
      Road, Jinsha Town, Tongzhou District, Nantong City, Jiangsu Province, China.
FAU - Zhang, Li
AU  - Zhang L
AD  - Department of Oncology, Affiliated Hospital of Nantong University, Tongzhou 
      District People's Hospital, Nantong City, Jiangsu Province, No. 115, Jianshe 
      Road, Jinsha Town, Tongzhou District, Nantong City, Jiangsu Province, China.
FAU - Cheng, Chun
AU  - Cheng C
AD  - Department of Immunology, School of Medicine, Nantong University, Jiangsu 
      Province, No. 19, Qixiu Road, Chongchuan District, Nantong City, Jiangsu 
      Province, China.
FAU - Chen, Da-Ke
AU  - Chen DK
AUID- ORCID: 0000-0003-2041-1686
AD  - Department of Oncology, Affiliated Hospital of Nantong University, Tongzhou 
      District People's Hospital, Nantong City, Jiangsu Province, No. 115, Jianshe 
      Road, Jinsha Town, Tongzhou District, Nantong City, Jiangsu Province, China.
LA  - eng
GR  - MSZ20213/the Project of Nantong Science and Technology Bureau/
PT  - Journal Article
PT  - Meta-Analysis
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Immune Checkpoint Inhibitors)
SB  - IM
MH  - Antineoplastic Agents/*therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols
MH  - Humans
MH  - Immune Checkpoint Inhibitors/*therapeutic use
MH  - Lung Neoplasms/*drug therapy/mortality
PMC - PMC8416009
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2021/09/04 06:00
MHDA- 2021/09/11 06:00
PMCR- 2021/09/03
CRDT- 2021/09/03 08:42
PHST- 2021/03/25 00:00 [received]
PHST- 2021/08/16 00:00 [accepted]
PHST- 2021/09/03 08:42 [entrez]
PHST- 2021/09/04 06:00 [pubmed]
PHST- 2021/09/11 06:00 [medline]
PHST- 2021/09/03 00:00 [pmc-release]
AID - 00005792-202109030-00043 [pii]
AID - MD-D-21-02382 [pii]
AID - 10.1097/MD.0000000000027121 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2021 Sep 3;100(35):e27121. doi: 
      10.1097/MD.0000000000027121.