Details

Autor(en) / Beteiligte

• Almutairi, Abdulaali R.
• Alkhatib, Nimer
• Martin, Jennifer
• Babiker, Hani M.
• Garland, Linda L.
• McBride, Ali
• Abraham, Ivo

Titel

Comparative efficacy and safety of immunotherapies targeting the PD-1/PD-L1 pathway for previously treated advanced non-small cell lung cancer: A Bayesian network meta-analysis

Ist Teil von

• Critical reviews in oncology/hematology, 2019-10, Vol.142, p.16-25

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2019

Quelle

Elsevier ScienceDirect Journals

Beschreibungen/Notizen

• [Display omitted] •Indirect comparisons yielded no differences in OS and PFS between PD-1/PD-L1 inhibitors in NSCLC.•Indirect comparisons showed higher ORR for pembrolizumab and nivolumab relative to atezolizumab.•Pembrolizumab ranked 1 st in OS/ORR and OS subgroups: adenoCa, EGFR mutant, ECOG 1, male, age <65y.•Nivolumab ranked 1 st in PFS and OS groups: squamous cell disease, EGFR-wild type, ECOG 0. Two PD-1 (pembrolizumab, nivolumab) and one PD-L1(atezolizumab) inhibitors are approved for previously treated advanced non-small cell lung cancer but have not been compared in head-to-head trials. A network meta-analysis was conducted to compare efficacy/safety of PD-1/PD-L1 inhibitors. In five-trials (including long-term updates) with docetaxel as common comparator there were no differences in OS and PFS between PD-1/PD-L1 inhibitors. Pembrolizumab (odds ratio(OR) = 2.22, 95%CrI = 1.28–3.70) and nivolumab (OR = 1.92, 95%CrI = 1.15–3.23) had higher ORRs than atezolizumab and at PD-L1 expression ≥50% and ≥1%. Probabilistically, pembrolizumab ranked first in OS and ORR, and in OS sub-analyses for adenocarcinoma, EGFR-mutant, ECOG-score-1, male, and age <65 years. Nivolumab ranked first in PFS, and in OS sub-analyses for squamous-cell disease, EGFR-wild-type, and ECOG-score-0. Pembrolizumab and nivolumab ranked the best option for most of adverse events. While pembrolizumab and nivolumab prevailed in rank in OS and ORR benefit, patient characteristics, safety and tolerance should be considered in treatment decision-making.