Programmed-death 1/programmed-death ligand 1 inhibitors plus chemotherapy versus chemotherapy for first-line treatment of advanced driver-gene negative non-squamous non-small cell lung cancer: An updated systematic review and meta-analysis.

IF 0.8 4区医学 Q4 ONCOLOGY

Indian journal of cancer Pub Date : 2026-01-01 Epub Date: 2026-06-09 DOI:10.4103/ijc.ijc_225_24

Zhifei Zhao, Wenfu Shi, Meng Yu, Xuefei Cheng

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引用次数: 0

Abstract

Background: To assess the efficacy and safety of first-line programmed-death 1 (PD-1)/programmed-death ligand 1 (PD-L1) inhibitors + chemotherapy for driver-gene negative advanced non-squamous non-small cell lung cancer (NSCLC).

Methods: Eligible literature was identified following a systematic search of four electronic databases (PubMed, Embase, Ovid, and Cochrane library databases) from their inception to June, 2023. Unpublished research was searched from the American Society of Clinical Oncology (ASCO), European Society for Medical Oncology (ESMO), and the World Conference on Lung Cancer (WCLC) meeting abstracts. Review Manager 5.3 software was used for analysis.

Results: Nine randomized controlled trials (RCTs) were identified and included, involving 3443 driver-gene negative advanced non-squamous NSCLC patients. PD-1/PD-L1 inhibitors + chemotherapy had significantly longer progression-free survival (PFS) (hazard ratio [HR] = 0.57, 95% CI = 0.52-0.61, P < 0.00001), and overall survival (OS) (HR = 0.69, 95% confidence interval = 0.63-0.76, P < 0.00001) compared with chemotherapy alone. Analysis was performed based on PD-L1 expression levels; patients with any PD-L1 expression had PFS benefit ( P < 0.00001), while only patients with PD-L1 ≥50% ( P = 0.02) and PD-L1 ≤1% ( P = 0.0009) had OS benefit. Regarding liver metastases, there was no statistically significant benefit of PD-1/PD-L1 inhibitors + chemotherapy regimens for the liver metastases cohort in OS ( P = 0.08). In brain metastasis patients, PD-1/PD-L1 inhibitors + chemotherapy regimens demonstrated an improvement in PFS compared to chemotherapy ( P = 0.03).

Conclusion: Our results show that PD-1/PD-L1 inhibitors + chemotherapy showed better survival benefits than chemotherapy in driver-gene negative advanced non-squamous NSCLC patients.

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程序性死亡1/程序性死亡配体1抑制剂联合化疗与化疗对晚期驱动基因阴性非鳞状非小细胞肺癌的一线治疗：最新的系统综述和荟萃分析

背景：评价一线程序性死亡1 (PD-1)/程序性死亡配体1 （PD-L1）抑制剂+化疗治疗驱动基因阴性晚期非鳞状非小细胞肺癌（NSCLC）的疗效和安全性。方法：系统检索四个电子数据库（PubMed、Embase、Ovid和Cochrane图书馆数据库）自建立至2023年6月的合格文献。未发表的研究从美国临床肿瘤学会（ASCO）、欧洲肿瘤医学学会（ESMO）和世界肺癌大会（WCLC）会议摘要中检索。使用Review Manager 5.3软件进行分析。结果：纳入9项随机对照试验（RCTs），涉及3443例驱动基因阴性的晚期非鳞状NSCLC患者。与单独化疗相比，PD-1/PD-L1抑制剂+化疗具有更长的无进展生存期（PFS）（风险比[HR] = 0.57, 95% CI = 0.52-0.61, P < 0.00001）和总生存期（OS）（HR = 0.69, 95%可信区间= 0.63-0.76,P < 0.00001）。根据PD-L1表达水平进行分析；任何PD-L1表达的患者都有PFS获益（P < 0.00001），而只有PD-L1≥50% （P = 0.02）和PD-L1≤1% （P = 0.0009）的患者有OS获益。对于肝转移，在OS中，PD-1/PD-L1抑制剂+化疗方案对肝转移队列没有统计学意义（P = 0.08）。在脑转移患者中，与化疗相比，PD-1/PD-L1抑制剂+化疗方案可改善PFS （P = 0.03）。结论：我们的研究结果表明，PD-1/PD-L1抑制剂+化疗在驱动基因阴性的晚期非鳞状NSCLC患者中比化疗具有更好的生存益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian journal of cancer Medicine-Oncology

CiteScore

1.40

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Indian Journal of Cancer (ISSN 0019-509X), the show window of the progress of ontological sciences in India, was established in 1963. Indian Journal of Cancer is the first and only periodical serving the needs of all the specialties of oncology in India.