PMID- 35688624
OWN - NLM
STAT- MEDLINE
DCOM- 20221118
LR  - 20221221
IS  - 1468-3296 (Electronic)
IS  - 0040-6376 (Linking)
VI  - 77
IP  - 12
DP  - 2022 Dec
TI  - Impact of PD1 and PDL1 immunotherapy on non-small cell lung cancer outcomes: a 
      systematic review.
PG  - 1163-1174
LID - 10.1136/thoraxjnl-2020-215614 [doi]
AB  - INTRODUCTION: Despite comprising many cancer diagnoses, few treatments are 
      suitable for patients with advanced non-small cell lung cancer (aNSCLC). Trials 
      suggest blockade of programmed death 1 (PD1) or its ligand (PDL1) may be 
      effective for these patients. However, this therapy's impact on outcomes other 
      than survival, and outcomes of patients not in trials, remains largely unknown. 
      Therefore, we compared the effectiveness of PD1 and PDL1 immunotherapy to 
      chemotherapy and placebo across multiple clinical outcomes. METHODS: Six 
      databases were searched on 12-13 October 2019 for randomised controlled trials 
      (RCTs) and observational studies investigating nivolumab, pembrolizumab, 
      atezolizumab or durvalumab. Study selection was performed independently by two 
      reviewers. Data for overall survival, progression-free survival, adverse effects 
      (AEs) and quality of life (QoL) were descriptively and meta-analysed. Factors 
      impacting treatment outcomes, including PDL1 expression, were explored. The 
      similarity between RCT and observational data was assessed. RESULTS: From 5423 
      search results, 139 full texts and abstracts were included. Immunotherapy was 
      associated with a lower risk of death than both comparators. In RCTs, the 
      incidence of treatment-related AEs was approximately 20% lower among patients 
      using immunotherapy compared with chemotherapy. However, no other consistent 
      benefits were observed. Progression-free survival results were inconsistent. 
      Improvements to QoL varied according to the instrument used; however, QoL was not 
      recorded widely. Survival results were similar between study designs; however, 
      AEs incidence was lower in observational studies. DISCUSSION: Among patients with 
      aNSCLC, immunotherapy improved overall survival and incidence of 
      treatment-related AEs compared with chemotherapy. Benefits to progression-free 
      survival and QoL were less consistent. PROSPERO REGISTRATION NUMBER: 
      CRD42019153345.
CI  - (c) Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Kanabar, Shivani Setur
AU  - Kanabar SS
AUID- ORCID: 0000-0002-3783-2244
AD  - Medical School, University of Birmingham College of Medical and Dental Sciences, 
      Birmingham, UK shivani.kanabar@outlook.com.
AD  - Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
FAU - Tiwari, Abhinav
AU  - Tiwari A
AD  - Medical School, University of Birmingham College of Medical and Dental Sciences, 
      Birmingham, UK.
FAU - Soran, Vina
AU  - Soran V
AD  - Medical School, University of Birmingham College of Medical and Dental Sciences, 
      Birmingham, UK.
FAU - Balendran, Prashanthan
AU  - Balendran P
AD  - Medical School, University of Birmingham College of Medical and Dental Sciences, 
      Birmingham, UK.
FAU - Price, Malcolm
AU  - Price M
AD  - Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
AD  - NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS 
      Foundation Trust, Birmingham, UK.
FAU - Turner, Alice Margaret
AU  - Turner AM
AUID- ORCID: 0000-0002-5947-3254
AD  - Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
DEP - 20220610
PL  - England
TA  - Thorax
JT  - Thorax
JID - 0417353
RN  - 31YO63LBSN (Nivolumab)
SB  - IM
CIN - Thorax. 2022 Dec;77(12):1159-1160. PMID: 36379682
MH  - Humans
MH  - *Carcinoma, Non-Small-Cell Lung/drug therapy
MH  - Immunotherapy/adverse effects
MH  - Nivolumab/therapeutic use
MH  - *Lung Neoplasms/drug therapy
OTO - NOTNLM
OT  - lung cancer
OT  - non-small cell lung cancer
COIS- Competing interests: None declared.
EDAT- 2022/06/11 06:00
MHDA- 2022/11/19 06:00
CRDT- 2022/06/10 21:22
PHST- 2020/06/22 00:00 [received]
PHST- 2022/05/11 00:00 [accepted]
PHST- 2022/06/11 06:00 [pubmed]
PHST- 2022/11/19 06:00 [medline]
PHST- 2022/06/10 21:22 [entrez]
AID - thoraxjnl-2020-215614 [pii]
AID - 10.1136/thoraxjnl-2020-215614 [doi]
PST - ppublish
SO  - Thorax. 2022 Dec;77(12):1163-1174. doi: 10.1136/thoraxjnl-2020-215614. Epub 2022 
      Jun 10.