Meta-Analysis on the Combination of Chemotherapy With Programmed Death-Ligand 1 and Programmed Cell Death Protein 1 Blockade as First-Line Treatment for Unresectable Pleural Mesothelioma.
J Thorac Oncol
; 19(1): 166-172, 2024 01.
Article
em En
| MEDLINE
| ID: mdl-37567387
ABSTRACT
INTRODUCTION:
Dual immune checkpoint blockers regimen represents a standard first-line therapy in unresectable pleural mesothelioma (PM). Novel combination strategies, including immune checkpoint blockers and antiangiogenic drugs, are currently under investigation in this setting. We aimed to assess the efficacy of the chemoimmunotherapy combination by reference to literature evidence.METHODS:
A systematic review and meta-analysis of trials with first-line platinum-based chemotherapy associated with programmed death-ligand 1 and programmed cell death protein 1 agent in unresectable PM. We estimated the weighted summary proportion of disease response, along with the landmark probability of survival outcomes.RESULTS:
A total of 349 patients with unresectable PM from four trials (DREAM, PrE0505, JME-001, and IND.227) were included, 79% (n = 274) with epithelioid and 21% (n = 75) with nonepithelioid histologic type. In aggregate, the objective response rate was 59.2% (95% confidence interval [CI] 50.3%-67.9%) and disease control rate was 92.2% (95% CI 89.2%-94.8%). Comparing epithelioid versus nonepithelioid tumors, the objective response rate was 64.5% versus 46.4%, (p < 0.001) and the disease control rate was 92.3% versus 80.0%, (p = 0.043), with an OR of 2.56 (95% CI 1.51-4.32) for disease response and of 3.37 (95% CI 0.99-11.47) for disease control. The aggregated estimated probability of progression-free survival was 63% (95% CI 53%-71%) at 6 months and 25% (95% CI 21%-31%) at 12 months, whereas the 6-, 12- and 24-month overall survival rates were 88% (95% CI 81%-93%), 71% (95% CI 61%-79%) and 39% (95% CI 34%-45%), respectively.CONCLUSIONS:
According to our analysis, first-line chemoimmunotherapy holds promise as a new treatment approach for PM, exhibiting encouraging survival outcomes and an enhanced response rate, including for the epithelioid subtype. Ongoing studies are necessary to establish its precise placement within the treatment algorithm.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Pleurais
/
Mesotelioma Maligno
/
Neoplasias Pulmonares
/
Mesotelioma
Tipo de estudo:
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
J Thorac Oncol
Ano de publicação:
2024
Tipo de documento:
Article