Efficacy and safety of immune checkpoint inhibitors in non-small cell lung cancer

Shuai Wang1, Jiatao Hao2, Hao Wang1

  • 1Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.

Oncoimmunology
|September 18, 2018
PubMed

Insights

Immune checkpoint inhibitors (ICIs) significantly improve survival and response rates in non-small cell lung cancer (NSCLC). These therapies show fewer adverse effects, establishing them as a preferred treatment for specific NSCLC patient groups.

Area of Science:

  • Oncology
  • Immunotherapy
  • Clinical Trials

Background:

  • Non-small cell lung cancer (NSCLC) is a leading cause of cancer mortality.
  • Immune checkpoint inhibitors (ICIs) represent a novel therapeutic class for NSCLC.
  • Quantitative evaluation of ICI efficacy and safety in NSCLC is crucial.

Purpose of the Study:

  • To quantitatively assess the efficacy and safety of immune checkpoint inhibitors (ICIs) in non-small cell lung cancer (NSCLC).
  • To identify patient subgroups that benefit most from ICI therapy.

Main Methods:

  • Systematic search of PubMed, Embase, Cochrane Library, and Web of Science for randomized clinical trials.
  • Meta-analysis of 12 trials including 6,919 NSCLC patients, adhering to PRISMA guidelines.
  • Pooled analysis of progression-free survival (PFS), overall survival (OS), objective response rates (ORR), and adverse events.

Main Results:

  • ICIs significantly improved PFS (HR 0.838), OS (HR 0.747), and ORR (RR 1.311) in NSCLC patients.
  • Benefits were observed across various demographics and clinical factors, but were limited in non-smokers, patients with CNS metastasis, EGFR mutations, or low PD-L1 expression.
  • ICIs demonstrated a reduced risk of several adverse events, including anemia, neutropenia, and nausea, compared to control therapies.

Conclusions:

  • Immune checkpoint inhibitors (ICIs) enhance PFS, OS, and ORR in NSCLC patients with a favorable safety profile.
  • ICIs are a preferred treatment option for NSCLC patients who are smokers, have no CNS metastasis, wild-type EGFR, and high PD-L1 expression.

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