Efficacy and safety of addition of anti-PD1 to chemotherapy in treatment of non-small cell lung cancer.

BACKGROUND: Patients with previously treated non-small-cell lung cancer (NSCLC) have limited treatment options. A novel treatment based on programed death 1 (PD-1)/programed death ligand 1 (PD-L1) inhibitors has emerged as promising therapeutic options for advanced NSCLC. We assessed oncological outcomes of PD-L1 antibody versus docetaxel in previously treated NSCLC.

OBJECTIVES: The purpose of this meta-analysis was to analysis the oncological outcomes of anti-PD1 to chemotherapy in treatment of non-small-cell lung cancer.

RESULTS: Overall survival (OR=0.68,95%CI=0.61-0.75, P<0.00001) and progression-free survival (OR=0.84,95%CI=0.77-0.92, P=0.0002) was longer with anti-PD1 than with docetaxel in NSCLC. Anti-PD1was associated with even greater objective response rate than docetaxel (OR=1.61,95%CI=1.16-2.24, P=0.004). Treatment-related adverse events of grade 3-5 did favor anti-PD1 over docetaxel (OR=0.21,95%CI=0.10-0.42, P<0.00001).

CONCLUSIONS: Among patients with advanced NSCLC, we found that there were a superior survival benefit and with a favorable safety profile with anti-PD1 than with docetaxel. More large-scale randomized controlled trials are needed to identify relevant biomarkers that have effect on predicting the population that would most likely benefit from PD-1/PD-L1 for pretreated advanced NSCLC patients.