Safety, efficacy, and quality of life with cemiplimab treatment among non-small cell lung cancer patients: a systematic review and meta-analysis.

Background: Immune checkpoint inhibitors have shown promise in treating advanced non-small cell lung cancer and have a solid safety profile. Cemiplimab can be used as monotherapy or in combination with chemotherapy for both squamous and non-squamous cancers. We opted for a systematic review and meta-analysis to find out the efficacy outcome and safety profile along with quality-of-life data of cemiplimab for advanced non-small-cell lung cancer (NSCLC).

Methods: A rigorous search of literature on PubMed, Embase, and Google Scholar was done to find relevant published publications till December 1, 2023. Outcomes like objective response rate (ORR), overall survival (OS), progression-free survival (PFS), common side effects, and quality of life among the cemiplimab and the control group were used to conduct meta-analysis using the fixed/random effect model for combined odds ratio (OR), combined hazard ratio (HR) and mean difference at confidence interval (CI) of 95%.

Results: Two randomized clinical trials EMPOWER 1 and EMPOWER 3 with 1092 advanced NSCLC patients along with their follow-up studies were included. There was significantly higher OS (HR = 0.62 [0.54, 0.70], P < 0.0001) and PFS (HR = 0.54 [0.48, 0.60], P < 0.0001] in the treatment group. Similarly, the combined ORR was significantly higher in the treatment group as compared to the control group (2.63 [95% CI: 2.17-3.20, P ≤ 0.001]). Treatment-emergent adverse effects were not different between the groups. Finally, the quality-of-life scores between the two groups were nonsignificant.

Conclusion: With regard to OS, PFS, ORR, quality of life scores, and an acceptable safety profile in advanced non-small cell lung cancer, cemiplimab showed clinically relevant and statistically significant improvements making it standard of care for such patients.