PMID- 37563966
OWN - NLM
STAT- MEDLINE
DCOM- 20231011
LR  - 20231011
IS  - 2045-7634 (Electronic)
IS  - 2045-7634 (Linking)
VI  - 12
IP  - 17
DP  - 2023 Sep
TI  - Meta-analysis of PD-(L)1 inhibitor plus chemotherapy versus chemotherapy as 
      first-line treatment in extensive-stage small-cell lung cancer.
PG  - 17924-17933
LID - 10.1002/cam4.6433 [doi]
AB  - BACKGROUND: Immunotherapy targeting programmed death 1(PD-1) and its ligand 
      (PD-L1) has been successful in extensive-stage small cell lung cancer (ES-SCLC). 
      However, first-line PD-(L)1 inhibitor combined with chemotherapy 
      (immunochemotherapy) versus chemotherapy has not been well studied. METHODS: 
      Randomized controlled trials had been searched from PubMed, Embase, and the 
      Cochrane Library until December 29, 2022. Randomized effect consistency models 
      were applied for estimating the pooled hazard ratios (HRs) and odds ratios (ORs). 
      Study outcomes included overall response rate (ORR), progression-free survival 
      (PFS), overall survival (OS), 6-month and 1-year disease progression rate, 1-year 
      and 2-year mortality rate, and Grade >/=3 adverse events (AEs). RESULTS: Six 
      eligible trials with 2600 ES-SCLC patients were included. Compared with 
      chemotherapy, immunochemotherapy significantly improved ORR (OR 1.32, 95% CI 
      1.07-1.63; p = 0.01), PFS (HR 0.68, 95% CI 0.58-0.78; p < 0.001), and OS (HR 
      0.72, 96% CI 0.66-0.78, p < 0.001) without increasing Grade >/=3 AEs (p = 0.07). 
      Compared with patients with chemotherapy, the 6-month disease progression rate 
      was reduced by 0.39 (p = 0.01) and the 1-year disease progression rate was 
      reduced by 0.75 (p < 0.001), the 1-year mortality rate was reduced by 0.33 
      (p < 0.001) and the 2-year mortality rate was reduced by 0.50 (p < 0.001) 
      respectively in patients with immunochemotherapy. However, patients with brain 
      metastases failed to prolong PFS and OS from immunochemotherapy (p > 0.05). 
      CONCLUSION: Compared with chemotherapy, PD-(L)1 inhibitor plus chemotherapy as 
      first-line treatment could improve the efficacy and prognosis of ES-SCLC patients 
      without more serious side effects. However, more research is needed to validate 
      these results.
CI  - (c) 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
FAU - Lu, Jiangyue
AU  - Lu J
AD  - Department of Radiation Oncology, The Fifth Medical Center of Chinese PLA General 
      Hospital, Beijing, China.
AD  - Medical School of Chinese PLA, Beijing, China.
FAU - Lei, Xiao
AU  - Lei X
AUID- ORCID: 0000-0002-0428-1749
AD  - Department of Radiation Oncology, The Fifth Medical Center of Chinese PLA General 
      Hospital, Beijing, China.
FAU - Zhang, Pei
AU  - Zhang P
AD  - Department of Radiation Oncology, The Fifth Medical Center of Chinese PLA General 
      Hospital, Beijing, China.
FAU - Du, Lehui
AU  - Du L
AD  - Department of Radiation Oncology, The Fifth Medical Center of Chinese PLA General 
      Hospital, Beijing, China.
FAU - Zhang, Zhibo
AU  - Zhang Z
AUID- ORCID: 0000-0001-8534-7190
AD  - The 78th Group Army Hospital of Chinese PLA, Mudanjiang, China.
FAU - Qu, Baolin
AU  - Qu B
AD  - Department of Radiation Oncology, The Fifth Medical Center of Chinese PLA General 
      Hospital, Beijing, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20230811
PL  - United States
TA  - Cancer Med
JT  - Cancer medicine
JID - 101595310
RN  - 0 (Immune Checkpoint Inhibitors)
SB  - IM
MH  - Humans
MH  - Disease Progression
MH  - Immunotherapy/methods
MH  - *Lung Neoplasms/drug therapy/pathology
MH  - *Small Cell Lung Carcinoma/drug therapy/pathology
MH  - *Immune Checkpoint Inhibitors/therapeutic use
MH  - Neoplasm Staging
PMC - PMC10524002
OTO - NOTNLM
OT  - chemotherapy
OT  - extensive-stage
OT  - immunotherapy
OT  - meta-analysis
OT  - small-cell lung cancer
COIS- All authors declare no conflict of interest.
EDAT- 2023/08/11 06:43
MHDA- 2023/10/04 06:43
PMCR- 2023/08/11
CRDT- 2023/08/11 03:10
PHST- 2023/05/29 00:00 [revised]
PHST- 2023/03/23 00:00 [received]
PHST- 2023/07/31 00:00 [accepted]
PHST- 2023/10/04 06:43 [medline]
PHST- 2023/08/11 06:43 [pubmed]
PHST- 2023/08/11 03:10 [entrez]
PHST- 2023/08/11 00:00 [pmc-release]
AID - CAM46433 [pii]
AID - 10.1002/cam4.6433 [doi]
PST - ppublish
SO  - Cancer Med. 2023 Sep;12(17):17924-17933. doi: 10.1002/cam4.6433. Epub 2023 Aug 
      11.