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Research article
Zhang Changgeng
Hengshui People's Hospital, Hebei Province
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background Atezolizumab was effective and well tolerated in pretreated non-small-cell lung cancer (NSCLC). This meta-analysis assessed that the efficacy and safety of atezolizumab plus chemotherapy combination, compared to chemotherapy alone.
Methods This meta-analysis included double-blind randomized controlled trials (RCTs) comparing atezolizumab plus chemotherapy combination with chemotherapy alone for NSCLC. The subgroups were the high expression of PD-L1（PD-L1-high）, the low expression of PD-L1 （PD-L1-low） and the negative expression of PD-L1 (PD-L1-negative). The hazard ratios (HRs) and odds ratios (ORs) with 95% confidence interval (CI) were calculated. The outcome parameters were overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and adverse events Grade 3-5（AEs G3-5）.
Results A total of 6 articles were included in this meta-analysis. The results indicated that atezolizumab plus chemotherapy combination had better efficacy than chemotherapy alone for PFS (HR=0.64, 95% CI=0.60 to 0.70,P<0.001), PFS（PD-L1-high）(HR=0.41, 95% CI=0.34 to 0.51,P<0.001), PFS（PD-L1-low）(HR=0.63,95% CI 0.55 to 0.72,P<0.001) and PFS（PD-L1-negative）(HR=0.71, 95% CI=0.61 to 0.83,P<0.001). There were statistically significant improvements in terms of OS (HR = 0.79, 95% CI = 0.73 to 0.86,P<0.001) 、OS (PD-L1-high) (HR = 0.65, 95% CI = 0.48 to 0.88,P<0.01) and OS (PD-L1-negative) (HR = 0.84, 95% CI = 0.72 to 0.98,P<0.05). Significant benefits were observed in ORR (OR=1.81,95% CI=1.58 to 2.08, P<0.001), ORR（PD-L1-high）(OR=2.24,95% CI=1.24 to 4.06,P<0.01), ORR（PD-L1-low）(OR=1.51,95% CI=1.03 to 2.21,P<0.05) and ORR（PD-L1-negative）(OR=1.54,95% CI=1.05 to 2.27,P<0.05). Meanwhile, atezolizumab was well tolerated and the incidence of AEs G3-5 (OR = 1.32, 95% CI = 1.06 to 1.64,P=0.01).
Conclusion The atezolizumab plus chemotherapy combination had excellent efficacy and great safety than chemotherapy alone for NSCLC. Furthermore, these benefits had nothing to do with the state of PD-L1 expression.
Keywords
Atezolizumab, Chemotherapy, PD-1/PD-L1, NSCLC
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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 article
Zhang Changgeng
Hengshui People's Hospital, Hebei Province
Corresponding Author
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 28 Sep, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cancer Biology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background Atezolizumab was effective and well tolerated in pretreated non-small-cell lung cancer (NSCLC). This meta-analysis assessed that the efficacy and safety of atezolizumab plus chemotherapy combination, compared to chemotherapy alone.
Methods This meta-analysis included double-blind randomized controlled trials (RCTs) comparing atezolizumab plus chemotherapy combination with chemotherapy alone for NSCLC. The subgroups were the high expression of PD-L1（PD-L1-high）, the low expression of PD-L1 （PD-L1-low） and the negative expression of PD-L1 (PD-L1-negative). The hazard ratios (HRs) and odds ratios (ORs) with 95% confidence interval (CI) were calculated. The outcome parameters were overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and adverse events Grade 3-5（AEs G3-5）.
Results A total of 6 articles were included in this meta-analysis. The results indicated that atezolizumab plus chemotherapy combination had better efficacy than chemotherapy alone for PFS (HR=0.64, 95% CI=0.60 to 0.70,P<0.001), PFS（PD-L1-high）(HR=0.41, 95% CI=0.34 to 0.51,P<0.001), PFS（PD-L1-low）(HR=0.63,95% CI 0.55 to 0.72,P<0.001) and PFS（PD-L1-negative）(HR=0.71, 95% CI=0.61 to 0.83,P<0.001). There were statistically significant improvements in terms of OS (HR = 0.79, 95% CI = 0.73 to 0.86,P<0.001) 、OS (PD-L1-high) (HR = 0.65, 95% CI = 0.48 to 0.88,P<0.01) and OS (PD-L1-negative) (HR = 0.84, 95% CI = 0.72 to 0.98,P<0.05). Significant benefits were observed in ORR (OR=1.81,95% CI=1.58 to 2.08, P<0.001), ORR（PD-L1-high）(OR=2.24,95% CI=1.24 to 4.06,P<0.01), ORR（PD-L1-low）(OR=1.51,95% CI=1.03 to 2.21,P<0.05) and ORR（PD-L1-negative）(OR=1.54,95% CI=1.05 to 2.27,P<0.05). Meanwhile, atezolizumab was well tolerated and the incidence of AEs G3-5 (OR = 1.32, 95% CI = 1.06 to 1.64,P=0.01).
Conclusion The atezolizumab plus chemotherapy combination had excellent efficacy and great safety than chemotherapy alone for NSCLC. Furthermore, these benefits had nothing to do with the state of PD-L1 expression.
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