Metastatic sites as predictors in advanced NSCLC treated with PD-1 inhibitors: a systematic review and meta-analysis.

Abstract

BACKGROUND:

Programmed cell death protein 1 (PD-1) inhibitors are the first-line treatment for advanced non-small-cell lung cancer (NSCLC) patients. However, their efficacy in metastatic NSCLC patients remains controversial.

AIM OF THE STUDY:

The aim of our study was to evaluate the prognosis of advanced metastatic NSCLC patients treated with PD-1 inhibitors, and discuss the predictive effect of metastatic site on the long-term outcome.

METHODS:

The Embase, Ovid Medline, Cochrane Central Register of Controlled Trials, and PubMed databases were systematically screened up to February 10, 2020. Twenty-five eligible studies, involving 8,067 patients that assessed the impact of metastatic sites on survival outcome were incorporated in our study. Overall survival (OS) and progression-free survival (PFS) were described as hazard ratio (HR) with 95% confidence interval (CI).

RESULTS:

Among the advanced NSCLC patients, the median proportion of brain, liver, bone, and adrenal gland metastases were 21%, 17%, 35%, and 21%, respectively. Patients with metastases to the brain, liver, and bone had worse OS compared to patients without these metastases when treated with PD-1 inhibitors. Similarly, patients with metastasis to the brain and liver were more likely to progress when treated with PD-1 inhibitors. Besides, patients with multiple metastatic sites had worse PFS compared to patients with one metastatic site, while no significant difference was found in terms of OS.

CONCLUSIONS:

Based on the findings of our systematic review and meta-analysis, metastatic sites were independent predictors of the survival outcome for advanced NSCLC patients treated with PD-1 inhibitors.

• Authors: Yangyun Huang, Lihuan Zhu, Tianxing Guo, Wenshu Chen, Zhenlong Zhang, Wujin Li, Xiaojie Pan
• Journal: Human vaccines & immunotherapeutics (Hum Vaccin Immunother) Vol. 17 Issue 5 Pg. 1278-1287 (05 04 2021) ISSN: 2164-554X [Electronic] United States
• PMID: 33079622 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• B7-H1 Antigen
• Immune Checkpoint Inhibitors

Topics

• B7-H1 Antigen
• Carcinoma, Non-Small-Cell Lung
• Humans
• Immune Checkpoint Inhibitors
• Lung Neoplasms (drug therapy)
• Progression-Free Survival