Related Experiment Video

Updated: Sep 15, 2025

Semi-automatic PD-L1 Characterization and Enumeration of Circulating Tumor Cells from Non-small Cell Lung Cancer Patients by Immunofluorescence
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Comparative efficacy of first-line therapies for PD-L1-negative advanced NSCLC: A network meta-analysis with

Jie-Tao Ma1, Mei-Qi Yang1, Shu-Ling Zhang1

  • 1Department of Oncology, Shengjing Hospital of China Medical University, Shenyang 110004, China.

Critical Reviews in Oncology/Hematology
|July 17, 2025
PubMed
Abstract

Insights

Optimal first-line treatment for PD-L1-negative advanced non-small cell lung cancer (NSCLC) involves subtype-specific strategies. Dual immunotherapy and anti-PD-1 plus chemotherapy offer comparable survival benefits, with bevacizumab-containing regimens for non-squamous NSCLC showing improved outcomes.

Area of Science:

  • Oncology
  • Immunotherapy
  • Clinical Trials

Background:

  • Optimal first-line treatment for programmed death-ligand 1 (PD-L1)-negative advanced non-small cell lung cancer (NSCLC) without actionable mutations is uncertain.
  • Histological subtype-driven strategies may improve outcomes in this patient population.

Purpose of the Study:

  • To evaluate and compare various first-line treatment regimens for PD-L1-negative advanced NSCLC.
  • To determine the efficacy of histology-driven treatment strategies in this patient group.

Main Methods:

  • Systematic review and network meta-analysis (NMA) of 24 randomized controlled trials.
  • Inclusion of 5035 patients with PD-L1-negative advanced NSCLC.
  • Survival curve reconstruction and statistical analyses using R and Stata.

Main Results:

  • Anti-PD-1 plus chemotherapy (CT) and anti-PD-1 plus anti-CTLA-4 showed comparable efficacy in histology-unselected NSCLC.
  • Bevacizumab plus anti-PD-(L)1 plus CT demonstrated the longest median progression-free survival (PFS) and overall survival (OS) in non-squamous NSCLC.
  • Anti-PD-1 plus CT significantly improved PFS and OS in squamous NSCLC, while anti-PD-L1 plus CT did not show significant benefits.

Conclusions:

  • Dual immunotherapy and anti-PD-1 plus CT offer comparable survival benefits for PD-L1-negative, histology-unselected NSCLC.
  • Personalized treatment strategies based on histology, such as bevacizumab-containing regimens for non-squamous and anti-PD-1 plus CT for squamous NSCLC, optimize patient outcomes.
Keywords:
ImmunotherapyNetwork meta-analysisNon-small cell lung cancerPD-L1-negativeReconstructed survival curves

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