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Anti-PD-1 Monoclonal Antibodies (mAbs) Are Superior to Anti-PD-L1 mAbs When Combined with Chemotherapy in First-Line Treatment for Metastatic Non-Small Cell Lung Cancer (mNSCLC): A Network Meta-Analysis.
Wei, Joe Q; Yuile, Alexander; Itchins, Malinda; Kong, Benjamin Y; Li, Bob T; Pavlakis, Nick; Chan, David L; Clarke, Stephen J.
Afiliação
  • Wei JQ; Royal North Shore Hospital, St Leonards, NSW 2065, Australia.
  • Yuile A; Northern Clinical School, University of Sydney, St Leonards, NSW 2065, Australia.
  • Itchins M; Royal North Shore Hospital, St Leonards, NSW 2065, Australia.
  • Kong BY; Northern Clinical School, University of Sydney, St Leonards, NSW 2065, Australia.
  • Li BT; Royal North Shore Hospital, St Leonards, NSW 2065, Australia.
  • Pavlakis N; Northern Clinical School, University of Sydney, St Leonards, NSW 2065, Australia.
  • Chan DL; Royal North Shore Hospital, St Leonards, NSW 2065, Australia.
  • Clarke SJ; Northern Clinical School, University of Sydney, St Leonards, NSW 2065, Australia.
Biomedicines ; 11(7)2023 Jun 26.
Article em En | MEDLINE | ID: mdl-37509467
ABSTRACT
Platinum-based chemotherapy combined with anti-PD-1 or PD-L1 monoclonal antibodies (mAbs) is now standard first-line therapy for mNSCLC patients without sensitizing driver mutations. Anti-PD-1 and anti-PD-L1 mAbs are considered to be equivalent in efficacy. In the absence of head-to-head randomized control trials (RCTs), we utilized network meta-analysis (NWM) to provide an indirect comparison of their efficacy. A systematic literature review and NWM were performed using RCTs that investigated anti-PD-1 or PD-L1 mAbs ± chemotherapy in patients with mNSCLC in the first-line setting. The primary outcome was comparative overall survival (OS), while secondary outcomes were comparative progression-free survival (PFS), objective response rate (ORR), and rate of grade 3 and higher toxicities. We identified 24 RCTs. Patients treated with anti-PD-1 mAb + chemotherapy compared with anti-PD-L1 mAb + chemotherapy showed superior mOS, mPFS, and ORR with a similar rate of grade 3 and higher toxicities. This difference in mOS was most pronounced in the PD-L1 TPS 1-49% population. The two mAbs were equivalent as single agents. Anti-PD-1 mAb + chemotherapy improved mOS when compared to anti-PD-1 mAb monotherapy, whereas anti-PD-L1 mAbs + chemotherapy did not when compared to anti-PD-L1 mAb monotherapy. Head-to-head RCTs are warranted in the future.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Systematic_reviews Idioma: En Revista: Biomedicines Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Austrália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Systematic_reviews Idioma: En Revista: Biomedicines Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Austrália