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.
Highlights
Lung cancer is one of the most common malignancies and is the leading cause of cancer-related deaths worldwide [1]
We demonstrated that the patients in anti-PD-1/PD-L1 antibody therapy groups had significantly longer overall survival (OS) (HR = 0.69, 95% confidence interval (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
The PD-1/PD-L1 pathway plays an important role in tumor immunologic escape [8]
Summary
Lung cancer is one of the most common malignancies and is the leading cause of cancer-related deaths worldwide [1]. Docetaxel is one of the most commonly used second-line regimens for NSCLC It prolongs survival of patients and relieves symptoms of the disease. In the past few years, targeted therapies, such as epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) receptor tyrosine kinase inhibitors, have achieved great success in the treatment of NSCLC. They effectively control tumor growth in patients harboring specific genetic mutations and rearrangements. In NSCLC patients who have undergone effective chemotherapy or targeted therapy, tumor progression may occur due to drug resistance, resulting in limited treatment options. It is necessary to explore a new way of treating these patients in order to prolong their survival time and improve their quality of life
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