TY - JOUR
T1 - Effectiveness and safety of immune checkpoint inhibitors for patients with advanced non small-cell lung cancer in real-world: Review and meta-analysis
AU - Mencoboni, Manlio
AU - Ceppi, Marcello
AU - Bruzzone, Marco
AU - Taveggia, Paola
AU - Cavo, Alessia
AU - Scordamaglia, Francesca
AU - Gualco, Marina
AU - Filiberti, Rosa Angela
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/3/2
Y1 - 2021/3/2
N2 - Immunotherapy based on anti PD-1/PD-L1 inhibitors is the new standard of advanced non-small cell lung cancers. Pembrolizumab, nivolumab and atezolizumab are used in clinical practice. The strict eligibility criteria of clinical trials do not allow researchers to fully represent treatment effects in the patients that will ultimately use these drugs. We performed a systematic review and a meta-analysis to evaluate the effectiveness and safety of these drugs, and more generally of ICIs, as second-line therapy in NSCLC patients in real world practice. MEDLINE, PubMed, Scopus and Web of Science were searched to include original studies published between January 2015 and April 2020. A total of 32 studies was included in the meta-analysis. The overall radiological response rate (ORR), disease control rate (DCR), median progression-free survival (PFS) and overall survival (OS) were 21%, 52%, 3.35 months and 9.98 months, respectively. The results did not change when analysis was adjusted for Eastern Cooperative Oncology Group performance status (ECOG PS) and age. A unitary increase in the percent of patients with liver and CNS metastases reduced the occurrence of DCR by 7% (p < 0.001) and the median PFS by 2% (p = 0.010), respectively. The meta-analysis showed that the efficacy and safety of immunotherapy in everyday practice is comparable to that in clinical trials.
AB - Immunotherapy based on anti PD-1/PD-L1 inhibitors is the new standard of advanced non-small cell lung cancers. Pembrolizumab, nivolumab and atezolizumab are used in clinical practice. The strict eligibility criteria of clinical trials do not allow researchers to fully represent treatment effects in the patients that will ultimately use these drugs. We performed a systematic review and a meta-analysis to evaluate the effectiveness and safety of these drugs, and more generally of ICIs, as second-line therapy in NSCLC patients in real world practice. MEDLINE, PubMed, Scopus and Web of Science were searched to include original studies published between January 2015 and April 2020. A total of 32 studies was included in the meta-analysis. The overall radiological response rate (ORR), disease control rate (DCR), median progression-free survival (PFS) and overall survival (OS) were 21%, 52%, 3.35 months and 9.98 months, respectively. The results did not change when analysis was adjusted for Eastern Cooperative Oncology Group performance status (ECOG PS) and age. A unitary increase in the percent of patients with liver and CNS metastases reduced the occurrence of DCR by 7% (p < 0.001) and the median PFS by 2% (p = 0.010), respectively. The meta-analysis showed that the efficacy and safety of immunotherapy in everyday practice is comparable to that in clinical trials.
KW - Atezolizumab
KW - Efficacy
KW - Immune checkpoint inhibitors
KW - Immunotherapy
KW - Nivolumab
KW - Non-small cell lung cancer
KW - NSCLC
KW - Pembrolizumab
KW - Real-life
KW - Safety
UR - http://www.scopus.com/inward/record.url?scp=85102717909&partnerID=8YFLogxK
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U2 - 10.3390/cancers13061388
DO - 10.3390/cancers13061388
M3 - Review article
AN - SCOPUS:85102717909
VL - 13
SP - 1
EP - 22
JO - Cancers
JF - Cancers
SN - 2072-6694
IS - 6
M1 - 1388
ER -