This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
jing zhu
Chongqing Medical University First Affiliated Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8828-579X
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objectives : As reported, nivolumab and pembrolizumab have shown to be superior to docetaxel in advanced NSCLC. Therefore, we performed a systematic review and network meta-analysis to compare the efficacy and safety of nivolumab and pembrolizumab.
Materials and Methods : Randomized controlled trials (RCTs) assessing the effect and safety of nivolumab or pembrolizumab versus docetaxel for patients with advanced NSCLC in the second-line treatment were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. After that, we performed pairwise direct meta-analyses (nivolumab vs. docetaxel and pembrolizumab vs. docetaxel) and indirect comparison (nivolumab vs. pembrolizumab) using network meta-analyses methods.
Results : Four RCTs involving 2391 patients were included in the meta-analysis. In analyses of overall survival (OS), progression-free survival (PFS) and overall response rate (ORR) in the direct meta-analysis, nivolumab and pembrolizumab both showed survival benefits when compared with docetaxel. For the indirect comparison, nivolumab show no signifcant difference in OS, PFS and ORR when compared with pembrolizumab (OS: HR 1.03; 95% CI 0.84–1.26; PFS: HR 0.95; 95% CI 0.80–1.14; ORR: HR 1.08; 95% CI 0.67–1.73). For the safety analysis, nivolumab and pembrolizumab both have less toxicity than docetaxel. In indirect comparison, nivolumab showed less all-grade toxicity (OR 0.71; 95% CI 0.49–1.04) and grade 3–5 toxicity (OR 0.32; 95% CI 0.21–0.49) when compared with pembrolizumab.
Conclusion : Our meta-analysis suggests that nivolumab and pembrolizumab demonstrated similar clinical benefit for patients with advanced NSCLC in the second-line treatment. It seems that nivolumab has less toxicity when compared with pembrolizumab.
Keywords
Comparative effectiveness, Network Meta-analysis, non-small-cell lung cancer (NSCLC), Nivolumab, Pembrolizumab
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
jing zhu
Chongqing Medical University First Affiliated Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8828-579X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 16 Mar, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Oncology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objectives : As reported, nivolumab and pembrolizumab have shown to be superior to docetaxel in advanced NSCLC. Therefore, we performed a systematic review and network meta-analysis to compare the efficacy and safety of nivolumab and pembrolizumab.
Materials and Methods : Randomized controlled trials (RCTs) assessing the effect and safety of nivolumab or pembrolizumab versus docetaxel for patients with advanced NSCLC in the second-line treatment were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. After that, we performed pairwise direct meta-analyses (nivolumab vs. docetaxel and pembrolizumab vs. docetaxel) and indirect comparison (nivolumab vs. pembrolizumab) using network meta-analyses methods.
Results : Four RCTs involving 2391 patients were included in the meta-analysis. In analyses of overall survival (OS), progression-free survival (PFS) and overall response rate (ORR) in the direct meta-analysis, nivolumab and pembrolizumab both showed survival benefits when compared with docetaxel. For the indirect comparison, nivolumab show no signifcant difference in OS, PFS and ORR when compared with pembrolizumab (OS: HR 1.03; 95% CI 0.84–1.26; PFS: HR 0.95; 95% CI 0.80–1.14; ORR: HR 1.08; 95% CI 0.67–1.73). For the safety analysis, nivolumab and pembrolizumab both have less toxicity than docetaxel. In indirect comparison, nivolumab showed less all-grade toxicity (OR 0.71; 95% CI 0.49–1.04) and grade 3–5 toxicity (OR 0.32; 95% CI 0.21–0.49) when compared with pembrolizumab.
Conclusion : Our meta-analysis suggests that nivolumab and pembrolizumab demonstrated similar clinical benefit for patients with advanced NSCLC in the second-line treatment. It seems that nivolumab has less toxicity when compared with pembrolizumab.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7
Figure 8
Figure 9
Figure 10
Figure 11
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