First-line immunochemotherapy for advanced NSCLC in Asian patients: a meta-analysis of phase 3 RCTs

Area of Science:

• Oncology
• Immunotherapy
• Clinical Trials

Background:

• PD-1/PD-L1 inhibitors plus chemotherapy (PC) are established treatments for advanced non-small cell lung cancer (NSCLC).
• Limited data exist on PC efficacy and safety specifically in Asian populations.
• Updated evidence from randomized controlled trials (RCTs) is needed.

Purpose of the Study:

• To analyze and compare the efficacy and safety of PC versus chemotherapy in Asian patients with stage IIIb-IV NSCLC.
• To provide updated evidence based on phase 3 RCTs.

Main Methods:

• Systematic search of six databases for phase 3 RCTs.
• Inclusion criteria: Asian patients with stage IIIb-IV NSCLC, comparing PC with chemotherapy.
• Primary endpoints: Overall Survival (OS) and Progression-Free Survival (PFS).

Main Results:

• 16 RCTs with 4,452 Asian patients were analyzed.
• PC significantly improved OS (HR: 0.68) and PFS (HR: 0.50) compared to chemotherapy alone.
• PC also showed higher objective response rates (RR: 1.62) and disease control rates (RR: 1.09).
• Increased immune-related adverse events (irAEs) were observed with PC therapy.

Conclusions:

• PC therapy offers significant survival benefits for Asian patients with stage IIIb-IV NSCLC.
• The increased incidence of irAEs necessitates close clinical attention and management.
• PC remains a valuable treatment option, but safety monitoring is crucial.