PMID- 34794831
OWN - NLM
STAT- MEDLINE
DCOM- 20220128
LR  - 20220531
IS  - 1879-114X (Electronic)
IS  - 0149-2918 (Linking)
VI  - 43
IP  - 11
DP  - 2021 Nov
TI  - Efficacy and Safety of Programmed Cell Death 1 Inhibitor Monotherapy Versus 
      Chemotherapy as Second-Line Treatment for Advanced Esophageal Cancer: A 
      Meta-analysis and Systematic Review.
PG  - 1997-2012
LID - S0149-2918(21)00391-X [pii]
LID - 10.1016/j.clinthera.2021.09.018 [doi]
AB  - PURPOSE: With programmed cell death 1 (PD-1) inhibitors approved for second-line 
      treatment of advanced esophageal cancer, immunotherapy and chemotherapy have 
      gradually become the main treatments for second-line treatment of patients with 
      advanced esophageal cancer (AEC). This meta-analysis and systematic review were 
      conducted to evaluate the efficacy and safety of PD-1 inhibitors monotherapy 
      versus chemotherapy in second-line treatment of AEC. METHODS: Eligible randomized 
      controlled trials were searched in PubMed, Embase, and the Cochrane Library and 
      abstracts presented at the American Society of Clinical Oncology or European 
      Society of Medical Oncology were reviewed to assess the efficacy and tolerability 
      of PD-1/programmed cell death ligand 1 (PD-L1) inhibitors relative to 
      chemotherapy for AEC from January 2016 to October 2020. Patients diagnosed with 
      AEC and progressing after first-line therapy were included in this study. Hazard 
      ratios (HRs) of progression-free survival (PFS) and overall survival (OS), risk 
      ratios (RRs) of objective response rate (ORR), and the odds ratios (ORs) of 
      adverse effects (AEs) were calculated. FINDINGS: The study included 4 randomized 
      controlled trials with 1683 patients. The results indicated that PD-1 inhibitors 
      prolonged the OS (HR = 0.79; 95% CI, 0.71-0.88; P < 0.01) and improved the ORR 
      (RR = 3.00; 95% CI, 2.36-3.82; P = 0.01) but did not improve the PFS (HR = 0.96; 
      95% CI, 0.76-1.20; P = 0.692) compared with chemotherapy in the second-line 
      treatment of AEC. PD-1 inhibitors alone were associated with a lower incidence of 
      all treatment-related AEs (OR = 0.29; 95% CI, 0.09-0.89; P = 0.03) and grade 3 to 
      5 treatment-related AEs (OR = 0.26; 95% CI, 0.16-0.44; P < 0.01) versus 
      chemotherapy. PD-1 inhibitors prolonged OS mainly in the following patient 
      groups: male, age <65 years, Eastern Cooperative Oncology Group performance 
      status of 1, or PD-L1 tumor proportion score >/=10%. Asian patients had a longer OS 
      than non-Asian patients (P = 0.01). IMPLICATIONS: The available evidence 
      indicates that the efficacy and tolerability of PD-1 inhibitors were better than 
      chemotherapy in the second-line treatment of AEC, and the benefiting population 
      of these patients was limited to males, those <65 years of age, those with a 
      Eastern Cooperative Oncology Group performance status of 1, or those with a PD-L1 
      tumor proportion score >/=10%. Notably, Asian patients receiving immune monotherapy 
      had longer OS than non-Asian patients.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Yang, Yong-Liang
AU  - Yang YL
AD  - The Second People's Hospital of Lianyungang, The Affiliated Hospital of Bengbu 
      Medical College, Lianyungang, Jiangsu, China.
FAU - Li, Zhi-Qiang
AU  - Li ZQ
AD  - The Second People's Hospital of Lianyungang, The Affiliated Hospital of Bengbu 
      Medical College, Lianyungang, Jiangsu, China.
FAU - Wang, Qiu-Lu
AU  - Wang QL
AD  - The Second People's Hospital of Lianyungang, The Affiliated Hospital of Bengbu 
      Medical College, Lianyungang, Jiangsu, China.
FAU - Gu, Jing-Jing
AU  - Gu JJ
AD  - The Second People's Hospital of Lianyungang, The Affiliated Hospital of Bengbu 
      Medical College, Lianyungang, Jiangsu, China.
FAU - Fang, Xin-Jian
AU  - Fang XJ
AD  - The Second People's Hospital of Lianyungang, The Affiliated Hospital of Bengbu 
      Medical College, Lianyungang, Jiangsu, China.
FAU - Huang, Guan-Hong
AU  - Huang GH
AD  - The Second People's Hospital of Lianyungang, The Affiliated Hospital of Bengbu 
      Medical College, Lianyungang, Jiangsu, China. Electronic address: 
      hghlyg0002@sina.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20211115
PL  - United States
TA  - Clin Ther
JT  - Clinical therapeutics
JID - 7706726
RN  - 0 (B7-H1 Antigen)
SB  - IM
MH  - Aged
MH  - Apoptosis
MH  - B7-H1 Antigen
MH  - *Carcinoma, Non-Small-Cell Lung
MH  - *Esophageal Neoplasms/drug therapy
MH  - Humans
MH  - *Lung Neoplasms
MH  - Male
MH  - Progression-Free Survival
OTO - NOTNLM
OT  - PD-1
OT  - PD-L1
OT  - advanced esophageal cancer
OT  - chemotherapy
OT  - efficacy
OT  - safety
EDAT- 2021/11/20 06:00
MHDA- 2022/01/29 06:00
CRDT- 2021/11/19 05:45
PHST- 2021/03/11 00:00 [received]
PHST- 2021/08/25 00:00 [revised]
PHST- 2021/09/24 00:00 [accepted]
PHST- 2021/11/20 06:00 [pubmed]
PHST- 2022/01/29 06:00 [medline]
PHST- 2021/11/19 05:45 [entrez]
AID - S0149-2918(21)00391-X [pii]
AID - 10.1016/j.clinthera.2021.09.018 [doi]
PST - ppublish
SO  - Clin Ther. 2021 Nov;43(11):1997-2012. doi: 10.1016/j.clinthera.2021.09.018. Epub 
      2021 Nov 15.