Pd-(L)1 inhibitors as monotherapy for the first-line treatment of non-small-cell lung cancer patients with high pd-l1 expression : A network meta-analysis
Majem, Margarita (Institut d'Investigació Biomèdica Sant Pau)
Cobo, Manuel (Hospital Regional Universitario de Málaga)
Isla, Dolores (Hospital Clínico Universitario "Lozano Blesa" de Zaragoza)
Marquez-Medina, Diego (Hospital Universitario Miguel Servet (Saragossa))
Rodríguez-Abreu, Delvys (Hospital Universitario Insular de Gran Canaria)
Casal-Rubio, Joaquín (Hospital Álvaro Cunqueiro (Vigo))
Moran-Bueno, Teresa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bernabé, Reyes (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Pérez-Parente, Diego (Medical Affairs Department. Roche Farma S.A)
Ruiz-Gracia, Pedro (Medical Affairs Department. Roche Farma S.A)
Arroyo, Marta Marina (Medical Affairs Department. Roche Farma S.A)
Paz-Ares, Luis (Hospital Universitario 12 de Octubre (Madrid))

Data:	2021
Resum:	Programmed cell death-ligand 1 (PD-L1) has emerged as a potential biomarker for selec-tion of patients more likely to respond to immunotherapy and as a prognostic factor in non-small cell lung cancer (NSCLC). In this network meta-analysis, we aimed to evaluate the efficacy of first-line anti-PD-(L)1 monotherapy in advanced NSCLC patients with high PD-L1 expression (≥50%) compared to platinum-based chemotherapy. We also evaluated efficacy outcomes according to tumor mutational burden (TMB). To that end, we conducted a systematic review. Six clinical trials with 2111 patients were included. In head-to-head comparisons, immunotherapy showed a significant improvement in progression-free survival (PFS: HRpooled = 0. 69, 95% CI: 0. 52-0. 90, p = 0. 007), overall survival (OS: HRpooled = 0. 69, 95% CI: 0. 61-0. 78; p < 0. 001) and overall response rate (ORR) (Risk ratio (RR)pooled = 1. 354, 95% CI: 1. 04-1. 762, p = 0. 024). In the assessment of relative efficacy for PFS through indirect comparisons, pembrolizumab (results from KEYNOTE-024) ranked highest followed by cemiplimab and atezolizumab, with statistical significance determined for some of the drugs. In terms of OS, cemiplimab ranked highest followed by atezolizumab and pembrolizumab, although non-significant OS was determined for these drugs. In conclusion, PD-(L)1 inhibitor mon-otherapy improves efficacy outcomes in the first line setting of advanced NSCLC patients with high PD-L1 expression. Evaluations with longer follow up are still needed to determine the superiority of any specific drug.
Nota:	Altres ajuts: Roche
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Matèria:	Non-small cell lung cancer ; Network meta-analysis ; Immunotherapy ; First-line treatment ; PD-(L)1 inhibitors ; Efficacy
Publicat a:	Journal of clinical medicine, Vol. 10 Núm. 7 (april 2021) , p. 1365, ISSN 2077-0383

DOI: 10.3390/jcm10071365
PMID: 33810441

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