Immunotherapy efficacy of strong positive PD-L1 expression non-small cell lung cancer (NSCLC) patients: A systematic review and meta-analysis.

Abstract

e21701 Background: Immune-checkpoint inhibitors (ICIs) based therapy has been approved as the new 1L standard of care in advanced PD-L1 strong positive (>=50%) non-small cell lung cancer (NSCLC). However, little is known about the differences of efficacy between monotherapy and combined therapy of checkpoint inhibitors. We did a systematic review and meta-analysis to assess the heterogeneity of efficacy between monotherapy and combined therapy in 1L PD-L1 strong positive NSCLC patients. Methods: We systematically searched PubMed, Cochrane library, Embase and and major conference proceedings from January 2000 to November 2019 for randomized controlled trials that had available hazard ratios (HRs) for death according to PD-L1 expression (>=50%). The primary outcome was the difference in overall survival (OS). We calculated the pooled overall survival HR and 95% CI in monotherapy and combined therapy in 1L PD-L1 strong positive NSCLC patients using a random-effects model. Results: A total of 2211 publications were retrieved through initial literature search, 10 randomized controlled trials were included for this meta-analysis. No statistical differences were found between ICIs monotherapy and combined therapy (HR 1.09, 95% CI 0.88- 1.35). Subgroup analysis showed that immune monotherapy has similar effects to immune combined chemotherapy (HR 1.24, 95% CI 0.90-1.71) and immune combined immunotherapy (HR 1.01, 95% CI 0.81-1.27). Conclusions: For PD-L1 strong positive (>=50%) NSCLC patients, ICIs monotherapy had similar efficacy when compared with ICIs combination therapy.