PMID- 36034821
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220830
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 13
DP  - 2022
TI  - Efficacy and safety of combined immunotherapy and antiangiogenesis with or 
      without chemotherapy for advanced non-small-cell lung cancer: A systematic review 
      and pooled analysis from 23 prospective studies.
PG  - 920165
LID - 10.3389/fphar.2022.920165 [doi]
LID - 920165
AB  - Purpose: Immune checkpoint and antiangiogenic inhibitors have a potentially 
      synergistic antitumor effect. We aimed to assess the efficacy and safety of 
      immunotherapy in combination with antiangiogenesis therapy with or without 
      chemotherapy in patients with advanced non-small-cell lung cancer (NSCLC). 
      Methods: PubMed, Embase, the Cochrane library, Google Scholar, Ovid, Scopus, and 
      Web of Science were searched for eligible trials. ClinicalTrials.gov and meeting 
      abstracts were also searched for qualified clinical studies. The inclusion 
      criteria were as follows: prospective studies (including single-arm studies) that 
      evaluated efficacy and/or toxicity of immunotherapy combined with antiangiogenic 
      agents (A + I) with or without chemotherapy (A + I + chemo) in patients with 
      advanced or metastatic NSCLC; and primary outcome of each study reported at least 
      one of these endpoints: progression-free survival (PFS), overall survival, 
      objective response rate (ORR), disease control rate (DCR), or adverse events 
      (AEs). Results: Twenty three prospective studies comprising 1,856 patients with 
      advanced NSCLC were included. The pooled ORR, median PFS and estimated overall 
      survival were 39%, 6.8 months [95% confidence interval (CI), 5.53-8.13], and 
      18.6 months in the overall group. Similar ORR and median PFS with A + I + chemo 
      versus A + I were observed in patients treated in first-line setting [59% and 
      9.47 months (95% CI, 6.45-12.49) versus 52% and 10.9 months (95% CI, 1.81-19.98), 
      respectively]. We also observed improved ORR and mPFS with A + I + chemo versus A 
      + I in subsequent-line setting [56% and 8.1 months (95% CI, 5.00-11.26) versus 
      22% and 5.1 months (95% CI, 4.01-6.15), respectively]. Efficacy of A + I + chemo 
      therapy was evident across different PD-L1 subgroups, especially in patients with 
      EGFR mutations [ORR: 59%; mPFS: 8.13 months (95% CI: 5.00-11.26)] or baseline 
      liver metastases. The incidence of AEs with a major grade of >/=3 in the overall, A 
      + I, and A + I + chemo groups were 4.1% vs. 5.5% vs. 3.4% for proteinuria, 13.7% 
      vs. 16.2% vs. 9.7% for hypertension, and 1.9% vs. 1.2% vs. 2.8% for rash, 
      respectively. No new safety signals were identified in this pooled analysis. 
      Conclusion: Immunotherapy combined with antiangiogenic agents with or without 
      chemotherapy showed encouraging antitumor activity and an acceptable toxicity 
      profile in treatment-naive or pretreated patients with advanced NSCLC. Doublet 
      treatment with immunotherapy and antiangiogenic agents might be a new option for 
      patients with advanced NSCLC, especially those who are treatment-naive or cannot 
      tolerate chemotherapy.
CI  - Copyright (c) 2022 Gao, Song, Sun, Wu, Yi, Zhang, Huang, Ma and Han.
FAU - Gao, Ruo-Lin
AU  - Gao RL
AD  - Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 
      China.
FAU - Song, Jun
AU  - Song J
AD  - Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 
      China.
FAU - Sun, Li
AU  - Sun L
AD  - Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 
      China.
FAU - Wu, Zhi-Xuan
AU  - Wu ZX
AD  - Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 
      China.
FAU - Yi, Xiao-Fang
AU  - Yi XF
AD  - Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 
      China.
FAU - Zhang, Shu-Ling
AU  - Zhang SL
AD  - Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 
      China.
FAU - Huang, Le-Tian
AU  - Huang LT
AD  - Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 
      China.
FAU - Ma, Jie-Tao
AU  - Ma JT
AD  - Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 
      China.
FAU - Han, Cheng-Bo
AU  - Han CB
AD  - Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 
      China.
LA  - eng
PT  - Systematic Review
DEP - 20220810
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC9399640
OTO - NOTNLM
OT  - angiogenesis inhibitors
OT  - chemotherapy
OT  - combination therapy
OT  - immunotherapy
OT  - non-small cell lung cancer
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/08/30 06:00
MHDA- 2022/08/30 06:01
PMCR- 2022/08/10
CRDT- 2022/08/29 05:15
PHST- 2022/04/14 00:00 [received]
PHST- 2022/07/12 00:00 [accepted]
PHST- 2022/08/29 05:15 [entrez]
PHST- 2022/08/30 06:00 [pubmed]
PHST- 2022/08/30 06:01 [medline]
PHST- 2022/08/10 00:00 [pmc-release]
AID - 920165 [pii]
AID - 10.3389/fphar.2022.920165 [doi]
PST - epublish
SO  - Front Pharmacol. 2022 Aug 10;13:920165. doi: 10.3389/fphar.2022.920165. 
      eCollection 2022.