Comparing PD-1/PD-L1 inhibitors versus chemotherapy in patients with previously treated advanced non-small-cell lung cancer.

This study investigated the effectiveness and safety outcomes of programmed death-1 (PD-1)/PD ligand 1 (PD-L1) inhibitors versus chemotherapy in patients with previously treated advanced non-small-cell lung cancer (NSCLC). The data showed that PD-1/PD-L1 inhibitors were safer and more effective than chemotherapy in these patients.

Standard treatment for advanced NSCLC involves surgical removal of solid tumors, chemotherapy, and radiotherapy. Despite current treatment options improving survival rates, advanced NSCLC can be difficult to treat.

Immunotherapy has been found to be effective in advanced NSCLC. PD-L1 is a protein that can be found in high numbers on cancer cells. These proteins can stop the immune system from killing cancerous cells. Pembrolizumab (Keytruda) and nivolumab (Opdivo) are examples of PD-1 and PD-L1 inhibitors that work by inhibiting (blocking) PD-L1. This inhibition triggers the immune system to attack tumor cells and kill them.

PD-L1 inhibitors as a first-line treatment have been found to significantly improve the outcomes of patients with advanced NSCLC. However, there are very few studies investigating the effectiveness and safety outcomes of PD-L1 inhibitors versus chemotherapy in patients with previously treated advanced NSCLC.

This study investigated 8 studies and involved 4122 patients with previously treated advanced NSCLC. 1979 patients received PD-L1 inhibitors while 2143 patients received conventional chemotherapy.

Patients who received PD-1/PD-L1 inhibitors as second-line or later-line treatment were 29% less likely to die than those who received conventional chemotherapy. PD-1/PD-L1 inhibitors also significantly improved the progression-free survival rate compared with chemotherapy drugs in these patients. Patients who received PD-1/PD-L1 inhibitors as second-line or later-line treatment were 2 times more likely to have a better response rate (partial or complete disappearance of the cancer) than those who received conventional chemotherapy.

Patients who received PD-1/PD-L1 inhibitors were 66% less likely to experience any side effects than those who received chemotherapy. They were also 85% less likely to experience severe side effects compared to those treated with chemotherapy.

This study concluded that PD-1/PD-L1 inhibitors were safer and more effective than chemotherapy in patients with previously treated advanced NSCLC.

The patients in the studies analyzed knew what treatments they were getting. This might have influenced the results. Most studies analyzed in this study involved European and American patients which could affect the conclusions.