Clinical Efficacy of Immune Checkpoint Inhibitors in Non–Small Cell Lung Cancer Patients with Liver Metastases: A Network Meta-Analysis of Nine Randomized Controlled Trials

Qing Yin; Longguo Dai; Ruizhu Sun; Ping Ke; Liya Liu; Bo Jiang

doi:10.4143/crt.2021.764

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자료유형: 학술저널

저자정보: Qing Yin (The Third Affiliated Hospital of Kunming Medical University Yunnan China) Longguo Dai (The Third Affiliated Hospital of Kunming Medical University Yunnan China) Ruizhu Sun (The Third Affiliated Hospital of Kunming Medical University Yunnan China) Ping Ke (The Third Affiliated Hospital of Kunming Medical University Yunnan China) Liya Liu (The Third Affiliated Hospital of Kunming Medical University Yunnan China) Bo Jiang (The Third Affiliated Hospital of Kunming Medical University Yunnan China)

저널정보: 대한암학회 Cancer Research and Treatment Cancer Research and Treatment 제54권 제3호

발행연도: 2022.7

수록면: 803 - 816 (14page)

DOI: 10.4143/crt.2021.764

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Purpose This network meta-analysis (NMA) was conducted to compare the efficacy of immune checkpoint inhibitors in advanced non–small cell lung cancer (NSCLC) patients with liver metastases.Materials and Methods English literature was retrieved from the PubMed, American Society of Clinical Oncology, and European Society for Medical Oncology databases from January 2015 to January 2021. We pooled the overall survival (OS) and progression-free survival (PFS) hazard ratios (HRs) using an NMA and ranked treatments by the surface under the cumulative ranking curve. Publication bias was evaluated by Begg’s and Egger’s tests. STATA 15.0 was used for the sensitivity analysis, and the remaining statistical analyses were performed using R 4.0.2.Results Nine eligible phase III randomized controlled trials were included, including 1,141 patients with liver metastases. Pembrolizumab+chemotherapy ranked highest, followed by atezolizumab+bevacizumab+chemotherapy and nivolumab. However, no significant difference in OS rates was observed across these three treatments (HR, 0.98; 95% confidence interval [CI], 0.43 to 2.22 for pembrolizumab+chemotherapy vs. atezolizumab+bevacizumab+chemotherapy; HR, 0.91; 95% CI, 0.52 to 1.57 for pembrolizumab+chemotherapy vs. nivolumab). Regarding the PFS rate, atezolizumab+bevacizumab+chemotherapy and pembro-lizumab+chemotherapy ranked highest and no significant difference was observed between them (HR, 0.79; 95% CI, 0.36 to 1.70 for atezolizumab+bevacizumab+chemotherapy vs. pembrolizumab+chemotherapy).Conclusion Pembrolizumab+chemotherapy, atezolizumab+bevacizumab+chemotherapy, and nivolumab were superior to other treatments in NSCLC patients with liver metastases. These new findings may help clinicians better select therapeutic strategies for NSCLC patients with liver metastases.

#Liver metastases #Advanced non-small cell lung cancer #Immune checkpoint inhibitors #Overall survival #Progression-free survival #Network meta-analysis

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