Effectiveness and safety of pembrolizumab for patients with advanced non-small cell lung cancer in real-world studies and randomized controlled trials: A systematic review and meta-analysis.

Background: Several randomized controlled trials (RCTs) have confirmed the favorable clinical benefit of pembrolizumab in advanced non-small cell lung cancer (NSCLC). However, considering the strict inclusion and exclusion criteria in clinical research, there are certain differences between patients in the real-world, it is unclear whether the findings of clinical trials are fully representative of the treatment efficacy in patients who will eventually use it. Therefore, to further comprehensively assess the efficacy and safety of pembrolizumab in NSCLC, we conducted a systematic review and meta-analysis based on the latest RCTs and real-world studies (RWSs). Methods: We systematically searched PubMed, Embase, The Cochrane Library, The Web of Science, and clinical trials.gov as of December 2021. RCTs and RWSs of patients receiving pembrolizumab monotherapy or in combination with chemotherapy for advanced NSCLC were included. Results: The meta-analysis ultimately included 11 RCTs and 26 RWSs with a total of 10,695 patients. The primary outcomes of this study were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), serious adverse events (SAEs), the incidence of severe pneumonia reactions, and drug-related mortality. Direct meta-analysis results showed that in RCTs, pembrolizumab in combination with chemotherapy was superior to chemotherapy in terms of OS (HR=0.60, 95%CI:0.50-0.73), PFS (HR=0.47, 95%CI:0.38-0.58) and ORR (OR=3.22, 95%CI:2.57-4.03); pembrolizumab monotherapy was superior to chemotherapy in terms of OS (HR=0.73, 95%CI:0.66-0.80) and ORR (OR=1.90, 95%CI:1.17-3.09), but comparable to chemotherapy in terms of PFS (HR=0.83, 95%CI:0.66-1.04). The ORR values in retrospective single-arm studies were 45% (40%-51%). Conclusion: In RCTs, pembrolizumab monotherapy or in combination with chemotherapy is more effective and safer than chemotherapy for advanced NSCLC. In RWSs, ECOG PS 0-1 was shown to correlate with PFS and OS for patients with NSCLC.

Disinfectant Performance of a Chlorine Regenerable Antibacterial Microfiber Fabric as a Reusable Wiper.

Rechargeable disinfectant performance of a microfiber fabric grafted with a halamine precursor, 3-allyl-5,5-dimethylhydantoin (ADMH), was tested in an actual use situation in a university student dining hall. The precursor was successfully incorporated onto the surfaces of polyester fibers by using a radical graft polymerization process through a commercial finishing facility. The N⁻H bonds of ADMH moieties on the fibers can be converted to biocidal N⁻Cl bonds, when the fabrics are washed in a diluted chlorine bleach containing 3000 ppm available chlorine, providing a refreshable disinfectant function. By wiping the surfaces of 30 tables (equivalent to 18 m²) with wet chlorinated fabrics, both Staphylococcus aureus and Escherichia coli in concentrations of 105 CFU/mL were totally killed in a contact time of 3 min. The disinfectant properties of the fabrics were still superior after 10 times successive machine washes (equivalent to fifty household machine washes), and rechargeable after wiping 30 tables before each recharge. Recharging conditions, such as temperature, time, active chlorine concentration and pH value of sodium hypochlorite solution, as well as the addition of a detergent, were studied. The product has the potential to improve public safety against biological contaminations and the transmission of diseases.