Abstract

Aim: To compare the efficacy and safety of first-line chemotherapy (Chemo) plus immune checkpoint inhibitors (ICIs) or bevacizumab (Bev) in advanced non-squamous non-small-cell lung cancer without EGFR mutations or ALK fusions. Methods: A network meta-analysis was conducted to synthesize relative treatment outcomes. Results: Chemo+ICIs is superior to Chemo+Bev in both overall survival (hazard ratio: 0.92; 95% CI: 0.88-0.96) and progression-free survival (hazard ratio: 0.93; 95% CI: 0.90-0.97), with comparable severe adverse events. However, for patients with liver metastasis, Chemo+Bev has a 59.8% probability of providing better overall survival benefit. For specific regimens, pembrolizumab+Chemo showed an absolute advantage over other regimens. Conclusion: First-line Chemo+ICIs is superior to Chemo+Bev in advanced non-squamous non-small-cell lung cancer except for patients with liver metastasis.

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