Atezolizumab Plus Chemotherapy Vs Chemotherapy Alone for Non-small Cell Lung Cancer: A Meta-analysis of Different PD-L1-expression Levels
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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Posted 28 Sep, 2020
On 13 Dec, 2020
Received 06 Dec, 2020
On 03 Dec, 2020
Received 17 Nov, 2020
On 15 Nov, 2020
Invitations sent on 23 Oct, 2020
On 20 Sep, 2020
On 19 Sep, 2020
On 19 Sep, 2020
On 16 Sep, 2020
Atezolizumab Plus Chemotherapy Vs Chemotherapy Alone for Non-small Cell Lung Cancer: A Meta-analysis of Different PD-L1-expression Levels
Posted 28 Sep, 2020
On 13 Dec, 2020
Received 06 Dec, 2020
On 03 Dec, 2020
Received 17 Nov, 2020
On 15 Nov, 2020
Invitations sent on 23 Oct, 2020
On 20 Sep, 2020
On 19 Sep, 2020
On 19 Sep, 2020
On 16 Sep, 2020
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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