Checkpoint Inhibitors Plus Chemotherapy for First-Line Treatment of Advanced Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Tun, Aung; Thein, Kyaw Zin; Thein, Wai L.; Guevara, Elizabeth

doi:10.2144/fsoa-2019-0081

Cited by 26 publications

(23 citation statements)

References 30 publications

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“…More specifically, oncogenic drivers such as activating mutations of the epidermal growth factor receptor (EGFR), as well as rearrangements of the anaplastic lymphoma kinase (ALK) or ROS proto-oncogene 1 (ROS1) are crucial targets for biological therapies in selected subgroups of NSCLC patients [1]. More recently, treatment with immune checkpoint inhibitors targeting the axis involving the programmed death protein 1 (PD-1) and its ligand (PD-L1) have revolutionized the management of a large proportion of NSCLC patients; with regards to immune checkpoint blockade, data on reliable predictive biomarkers are limited in comparison with targeted agents, although the expression of PD-L1 in tumor specimens is currently employed for the selection of patients considered eligible for first-line treatment with single-agent immune checkpoint inhibitors [2].…”

Section: Introductionmentioning

confidence: 99%

Liquid Biopsy in Non-Small Cell Lung Cancer: Highlights and Challenges

Rijavec

Coco

Genova

et al. 2019

Cancers

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Non-small cell lung cancer is one leading cause of death worldwide, and patients would greatly benefit from an early diagnosis. Since targeted and immunotherapies have emerged as novel approaches for more tailored treatments, repeated assessments of the tumor biology have become pivotal to drive clinical decisions. Currently, tumor tissue biopsy is the gold standard to investigate potentially actionable biomarkers, but this procedure is invasive and may prove inadequate to represent the whole malignancy. In this regard, liquid biopsy represents a minimally invasive and more comprehensive option for early detection and investigation of this tumor. Today, cell-free DNA is the only approved circulating marker to select patients for a targeted therapy. Conversely, the other tumor-derived markers (i.e., circulating tumor cells, miRNAs, exosomes, and tumor educated platelets) are still at a pre-clinical phase, although they show promising results for their application in screening programs or as prognostic/predictive biomarkers. The main challenges for their clinical translation are the lack of reliable cutoffs and, especially for miRNAs, the great variability among the studies. Moreover, no established tool has been approved for circulating tumor cells and exosome isolation. Finally, large prospective clinical trials are mandatory to provide evidence of their clinical utility.

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Section: Introductionmentioning

confidence: 99%

Liquid Biopsy in Non-Small Cell Lung Cancer: Highlights and Challenges

Rijavec

Coco

Genova

et al. 2019

Cancers

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“…Non-small cell lung cancer (NSCLC) accounts for 80-90% of lung cancer. Up to approximately 55% of cases are diagnosed at a metastatic stage, which leads to poor long-term prognosis [2].…”

Section: Introductionmentioning

confidence: 99%

Cost effectiveness of immune checkpoint inhibitors for treatment of non-small cell lung cancer: A systematic review

et al. 2020

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Background Immune checkpoint inhibitors (ICIs) for treatment of non-small cell lung cancer (NSCLC) have been rapidly evolving. ICIs are likely to be more effective but also lead to escalating healthcare costs. Objectives The aim of this study was to evaluate the cost effectiveness of immune checkpoint inhibitors (ICIs) for treatment of non-small cell lung cancer (NSCLC). Methods We searched the PubMed, Web of Science, and Cochrane Library for studies comparing the cost effectiveness of ICIs for NSCLC. Potential studies identified were independently checked for eligibility by two authors, with disagreement resolved by a third reviewer. Quality of the included studies was evaluated using Consolidated Health Economic Evaluation Reporting Standards checklists. Results A total of 22 economic studies were included. Overall reporting of the identified studies largely met CHEERS recommendations. In the first-line setting, for advanced or metastatic NSCLC patients with PD-L1 � 50%, pembrolizumab appeared cost-effective compared with platinum-based chemotherapy in the US and Hong Kong (China), but not in the UK and China. The cost-effectiveness of pembrolizumab versus chemotherapy for first-line treatment of NSCLC in PD-L1 � 1% patients remained obscure. Regardless of PD-L1 expression status, pembrolizumab in combination with chemotherapy could be a cost-effective first-line therapy in the US. On the contrary, addition of atezolizumab to the combination of

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“…Immunotherapy can be administered alone as first line treatment in NSCLC if PD-L1≥50% or in combination with chemotherapy if we have low PD-L1 expression [ [17] , [18] , [19] ]. In any case it is a very efficient treatment modality.…”

Section: Discussionmentioning

confidence: 99%

Acute pneumothorax due to immunotherapy administration in non-small cell lung cancer

Sardeli

Romanidis

Οικονόμου

et al. 2020

Respiratory Medicine Case Reports

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Nowadays we have novel therapies for advanced stage non-small cell lung cancer. Immunotherapy has been introduced in the market for several years and until now its administration is mostly based on the programmed death-ligand 1. First line treatment with immunotherapy can be administered alone if programmed death-ligand 1 expression is ≥ 50%. All therapies for advanced stage disease have advantages and disadvantages, immunotherapy until now has presented mild adverse effects when compared to chemotherapy. However; it is known to induce inflammatory response to different tissues within the body. In our case acute pneumothorax was induced after immunotherapy administration.

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Checkpoint Inhibitors Plus Chemotherapy for First-Line Treatment of Advanced Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cited by 26 publications

References 30 publications

Liquid Biopsy in Non-Small Cell Lung Cancer: Highlights and Challenges

Liquid Biopsy in Non-Small Cell Lung Cancer: Highlights and Challenges

Cost effectiveness of immune checkpoint inhibitors for treatment of non-small cell lung cancer: A systematic review

Acute pneumothorax due to immunotherapy administration in non-small cell lung cancer

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