The efficacy and safety of anti-PD-1/PD-L1 antibody therapy versus docetaxel for pretreated advanced NSCLC: a meta-analysis

Guanghong Huang, Xin Sun, Dapeng Liu, Yunfeng Zhang, Boxiang Zhang, Guodong Xiao, Xiang Li, Xiao Gao, Chenhao Hu, Meng Wang, Hong Ren, Sida Qin, Guanghong Huang, Xin Sun, Dapeng Liu, Yunfeng Zhang, Boxiang Zhang, Guodong Xiao, Xiang Li, Xiao Gao, Chenhao Hu, Meng Wang, Hong Ren, Sida Qin

Abstract

Antibodies against the immune checkpoint proteins PD-1 and PD-L1 are novel therapeutic drugs for the treatment of advanced non-small cell lung cancer (NSCLC). Many clinical trials involving these drugs achieved breakthroughs in patients previously treated for advanced NSCLC. However, the results of these clinical studies are not consistent. In this report, we performed a meta-analysis to assess the efficacy and safety of anti-PD-1/PD-L1 antibodies compared with docetaxel treatment for advanced NSCLC patients from 5 randomized clinical trials. We demonstrated that the patients in anti-PD-1/PD-L1 antibody therapy groups had significantly longer overall survival (OS) (HR = 0.69, 95% CI 0.63-0.75, P < 0.05) and progression-free survival (PFS) (HR = 0.76, 95% CI 0.63-0.92, P < 0.05) than those in chemotherapy groups, especially PD-L1 positive patients. Anti-PD-1/PD-L1 antibodies improved the objective response rate (ORR) compared with docetaxel (OR = 1.64, 95% CI 1.19-2.26, p < 0.05). In addition, the anti-PD-1/PD-L1 antibody therapy had fewer treatment-related adverse events (AEs) (OR = 0.33, 95% CI 0.28-0.39, P < 0.05) than docetaxel, especially the grade ≥3 AEs (OR = 0.18, 95% CI 0.12-0.28, P < 0.001). In conclusion, our study revealed that, compared with docetaxel, anti-PD-1/PD-L1 antibody therapy improved clinical efficacy and safety in previously treated advanced NSCLC patients. This therapy may be a promising treatment for advanced NSCLC patients.

Keywords: Immune checkpoint inhibitor; NSCLC; PD-1/PD-L1; meta-analysis.

Conflict of interest statement

CONFLICTS OF INTEREST The authors declare no conflicts of interest.

Figures

Figure 1. Flowchart of selecting relevant studies
Figure 1. Flowchart of selecting relevant studies
Figure 2. The forest plot of the…
Figure 2. The forest plot of the overall survival (OS) in advanced NSCLC patients who received anti-PD1/PD-L1 antibody therapy compared to docetaxel
(A) total; (B) subgroup analysis of OS based on PD-L1 expression level.
Figure 3. The forest plot of the…
Figure 3. The forest plot of the progression-free survival (PFS) in advanced NSCLC patients who received anti-PD1/PD-L1 antibody therapy compared to docetaxel
(A) total; (B) subgroup analysis of PFS based on PD-L1 expression level.
Figure 4. The forest plot of the…
Figure 4. The forest plot of the objective response rate (ORR) in advanced NSCLC patients who received anti-PD1/PD-L1 antibody therapy compared to docetaxel
Figure 5. The forest plot of the…
Figure 5. The forest plot of the adverse events (AEs) in advanced NSCLC patients who received anti-PD1/PD-L1 antibody therapy compared to docetaxel
(A) treatment-related AEs; (B) severe treatment-related AEs (Grade ≥ 3).

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