PMID- 36523992
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221222
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 12
DP  - 2022
TI  - Comparison of the efficacy and safety in the treatment strategies between 
      chemotherapy combined with antiangiogenic and with immune checkpoint inhibitors 
      in advanced non-small cell lung cancer patients with negative PD-L1 expression: A 
      network meta-analysis.
PG  - 1001503
LID - 10.3389/fonc.2022.1001503 [doi]
LID - 1001503
AB  - BACKGROUND: In the first-line treatment of advanced non-small cell lung cancer 
      (NSCLC), for those patients with negative PD-L1 expression, which treatment 
      strategy has the better efficacy and safety between chemotherapy combined with 
      antiangiogenic and with immune checkpoint inhibitors (ICIs) is still unclear due 
      to the absence of head-to-head clinical trials. This study aims to answer the 
      question by performing a systematic review and network meta-analysis (NMA). 
      METHODS: Electronic databases (PubMed, Embase, Cochrane Library, Web of Science, 
      and ClinicalTrials.gov) were systematically searched accordingly to extract 
      eligible studies from inception to October 2022, as well as the abstracts from 
      the most recent main oncology congresses (American Association for Cancer 
      Research (AACR), American Society of Clinical Oncology (ASCO), World Conference 
      on Lung Cancer (WCLC), and European Society for Medical Oncology (ESMO)). Overall 
      survival (OS), progression-free survival (PFS), and adverse events (AEs) of 
      grades 3 to 5 were independently extracted and collected by two reviewers based 
      on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 
      (PRISMA) guideline. We used Cochrane's risk of bias tool for randomized 
      controlled trials through RevMan 5.3 to ascertain the quality of the included 
      studies. NMA with a Bayesian random-effects model was performed by R (version 
      4.0.4). RESULTS: According to the ranking list from OS-NMA, pembrolizumab 
      combined with chemotherapy has the most effective ranking first (surface under 
      the cumulative ranking (SUCRA) = 0.809844) (pooled HR = 0.65 [0.51-0.83]). On 
      PFS, the triple combination of nivolumab/bevacizumab/chemotherapy ranks first 
      (NMA estimate: HR = 0.35 [0.28-0.43]). On safety, in combination with 
      chemotherapy, sintilimab has minimal toxicity, followed by pembrolizumab+chemo. 
      CONCLUSIONS: In advanced NSCLC patients with negative PD-L1 expression, 
      pembrolizumab+chemo ranks first in the efficacy of OS and does not apparently 
      increase the incidence of any grade >/= 3 AE as compared with chemo alone. On PFS, 
      pembrolizumab also has advantages, but for patients with squamous cell carcinoma, 
      camrelizumab+chemo seems to be a better choice. SYSTEMATIC REVIEW REGISTRATION: 
      https://www.crd.york.ac.uk/prospero/, identifier CRD42021231441.
CI  - Copyright (c) 2022 Li, Chen, Hu, Qiang, Chang, Qian, Shen, Cai and Chu.
FAU - Li, Jiaqi
AU  - Li J
AD  - Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai Jiaotong 
      University, Shanghai, China.
FAU - Chen, Yingjie
AU  - Chen Y
AD  - School of Public Health, Shanghai Jiaotong University, Shanghai, China.
FAU - Hu, Fan
AU  - Hu F
AD  - School of Public Health, Shanghai Jiaotong University, Shanghai, China.
FAU - Qiang, Huiping
AU  - Qiang H
AD  - Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai Jiaotong 
      University, Shanghai, China.
FAU - Chang, Qing
AU  - Chang Q
AD  - Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai Jiaotong 
      University, Shanghai, China.
FAU - Qian, Jialin
AU  - Qian J
AD  - Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai Jiaotong 
      University, Shanghai, China.
FAU - Shen, Yinchen
AU  - Shen Y
AD  - Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai Jiaotong 
      University, Shanghai, China.
FAU - Cai, Yong
AU  - Cai Y
AD  - School of Public Health, Shanghai Jiaotong University, Shanghai, China.
FAU - Chu, Tianqing
AU  - Chu T
AD  - Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai Jiaotong 
      University, Shanghai, China.
LA  - eng
PT  - Systematic Review
DEP - 20221129
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC9746688
OTO - NOTNLM
OT  - antiangiogenic therapy
OT  - combination
OT  - immune checkpoint inhibitors (ICIs)
OT  - negative PD-L1 expression
OT  - network meta-analysis (NMA)
OT  - non-small cell lung cancer (NSCLC)
OT  - programmed cell death ligand-1 (PD-L1)
OT  - survival analysis
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. All authors have completed the ICMJE uniform disclosure 
      form.
EDAT- 2022/12/17 06:00
MHDA- 2022/12/17 06:01
PMCR- 2022/01/01
CRDT- 2022/12/16 02:32
PHST- 2022/08/16 00:00 [received]
PHST- 2022/10/25 00:00 [accepted]
PHST- 2022/12/16 02:32 [entrez]
PHST- 2022/12/17 06:00 [pubmed]
PHST- 2022/12/17 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2022.1001503 [doi]
PST - epublish
SO  - Front Oncol. 2022 Nov 29;12:1001503. doi: 10.3389/fonc.2022.1001503. eCollection 
      2022.