Meta-Analysis of Atezolizumab vs Docetaxel in Non-Small Cell Lung Cancer Treatment Outcomes

We aimed to investigate the clinical efficacy of atezolizumab and docetaxel in the treatment of non-small cell lung cancer (NSCLC) via meta-analysis and systematic review.

Publications were searched from China National Knowledge Infrastructure (CNKI), Chongqing Vipers Chinese Science and Technology Journal database (VIP), Wanfang database, PubMed database, Embase database, Cochrane Library and Web of Science. Randomized controlled trials (RCTs) of atezolizumab and docetaxel in the treatment of patients with NSCLC were collected. The retrieval period was from the establishment of the database to November 2021 and updated on 22 April 2023. According to the inclusion and exclusion criteria, the included studies were screened and quality evaluated. Meta-analysis was performed using RevMan 5.4.3 (Cochrane Training, Summertown, Oxford UK) software.

A total of 6 RCTs were included in our analysis, including 6348 patients with NSCLC. Our results showed that the atezolizumab group had significantly longer overall survival (OS) than the docetaxel group (hazard ratio [HR] = 0.77; 95% CI, 0.73-0.81); P < .00001). In terms of progression-free survival (PFS) and objective response rate (ORR), the atezolizumab group was not significantly superior to the docetaxel group (HR = 0.96; 95% CI, 0.90-1.02; P = .20), (relative ratio [RR] = 1.10, 95% CI, 0.95-1.26; P = .20). In terms of treatment-related adverse events (TRAEs), after treatment, the number of patients with TRAEs in the atezolizumab group was significantly lower than in the docetaxel group (RR = 0.65; 95% CI, 0.54-0.79; P < .00001).

Compared with docetaxel, atezolizumab can significantly prolong OS in patients with NSCLC and reduce the occurrence of TRAEs, but there is no advantage in PFS or ORR remission rate. Due to some limitations in case numbers and quality of included studies, multicenter, large sample, high-quality RCTs are still needed for further validation.