Posted by Medivizor on Sep 4, 2017 in Lung cancer |
In a nutshell
This meta-analysis looks at the safety and effectiveness of a new type of treatment called immune checkpoint inhibitors (ICIs). The authors concluded that ICIs are safe and effective treatment for patients with advanced non-small-cell lung cancer (NSCLC).
Some background
The emergence of targeted therapy has been beneficial for several types of cancer. Immune checkpoint inhibitors (ICIs) are a new type of anti-cancer treatment that target specific genetic mutations (changes). They work by blocking a protein called PD-L1 that is present on tumor cells. This then activates immune cells to fight the cancer cells. Markers need to be identified that would help predict whether this treatment would be more beneficial for certain patients with NSCLC compared to current available treatments.
Methods & findings
This meta-analysis looked at the effectiveness and safety of ICIs compared to current second-line treatment docetaxel (Taxotere) for patients with advanced NSCLC. They also aimed to see whether there was a link between the amount of PD-L1 protein in a patient and the benefits of ICIs.
5 studies were included with a combined total of 3579 patients. 1851 patients in group 1 were treated with ICIs and 1728 patients in group 2 were treated with docetaxel.
Overall survival (OS, time from beginning trial until death from any cause) was improved with ICI treatment. Group 1 patients had a 31% decrease in risk of death compared to patients in group 2.
Progression free survival (PFS, time from beginning trial until disease progression) was 13% improved for group 1 patients compared to group 2 patients.
Objective response rate (ORR, percent of patients with tumor reduction) was 53% improved for group 1 patients compared to group 2 patients.
Group 1 patients with higher levels of PD-L1 had the best OS, PFS and ORR.
Group 1 patients had higher incidences of side effects including rash, overactive thyroid, pneumonitis (inflammation of the lung) and colitis (inflammation of the colon) than group 2 patients. Group 1 patients had a lower incidence of side effects including nausea, fatigue, low red and white blood cell levels, diarrhea, and hair loss. Overall, group 1 patients had a lower incidence of grade 3 and 4 side effects than group 2 patients.
The bottom line
The authors concluded that ICIs are tolerable and effective for treating patients with advanced NSCLC. They suggest that patients with higher levels of PD-L1 should be treated with ICIs.
Published By :
Oncotarget
Original Title :
PD-1/PD-L1 antibodies efficacy and safety versus docetaxel monotherapy in advanced NSCLC patients, after first-line treatment option: systems assessment.
