Efficacy and safety of immune checkpoint inhibitors for individuals with advanced EGFR-mutated non-small-cell lung cancer who progressed on EGFR tyrosine-kinase inhibitors: a systematic review, meta-analysis, and network meta-analysis

Zhao, Yi; He, Ying; Wang, Wei; Cai, Qi; Ge, Fan; Chen, Zisheng; Zheng, Jianqi; Zhang, Yuan; Deng, Hongsheng; Chen, Ying; Lao, Shen; Liang, Hengrui; Liang, Wenhua; He, Jianxing

doi:10.1016/s1470-2045(24)00379-6

The Lancet Oncology

2024

DOI: 10.1016/s1470-2045(24)00379-6

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Efficacy and safety of immune checkpoint inhibitors for individuals with advanced EGFR-mutated non-small-cell lung cancer who progressed on EGFR tyrosine-kinase inhibitors: a systematic review, meta-analysis, and network meta-analysis

Yi Zhao,

Ying He,

Wei Wang

et al.

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Cited by 2 publications

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Efficacy and safety of immune checkpoint inhibitors for EGFR mutated non-small cell lung cancer: a network meta-analysis

Zhu,

He,

Xie

et al. 2024

Front. Immunol.

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IntroductionNon-small cell lung cancer (NSCLC) constitutes approximately 80–85% of cancer-related fatalities globally, and direct and indirect comparisons of various therapies for NSCLC are lacking. In this study, we aimed to compare the efficacy and safety of immune checkpoint inhibitors (ICIs) in patients with epidermal growth factor receptor (EGFR)-mutated NSCLC.MethodsThe electronic databases were systematically searched from inception until March 18, 2024. Studies comparing two or more treatments involving ICIs in patients with EGFR-mutated NSCLC were included. The primary endpoints were overall survival (OS) and progression-free survival (PFS), and the secondary endpoints were overall response rate (ORR), any grade adverse events (AEs), grade ≥3 AEs, and AEs requiring treatment discontinuation. The R software with the gemtc package was used to compare the outcomes of the different treatments.ResultsIn 11 eligible studies involving 1462 patients and 5 regimens (chemotherapy [chemo], ICI, ICI+chemo, antiangiogenesis+chemo, and ICI+antiangiogenesis+chemo), ICI+antiangiogenesis+chemo achieved the most favorable OS compared to chemo (HR=0.74, 95% CI 0.41–1.23), ICI+chemo (HR=0.94, 95% CI 0.57–1.46), and ICI (HR=0.58, 95% CI 0.27–1.08) and a nearly equivalent effect to antiangiogenesis+chemo (HR=1.01, 95% CI 0.52–1.92). The PFS and ORR results were similar to those of OS. ICI monotherapy exhibited the lowest toxicity profile.ConclusionsThese findings indicate that ICI+antiangiogenesis+chemo may be potentially beneficial for patients with EGFR-mutated NSCLC. However, the observed difference was not significant; thus, more studies are needed to confirm the efficacy and safety of the combined ICI treatment strategy.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023424781.

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Efficacy and safety of immune checkpoint inhibitors for EGFR mutated non-small cell lung cancer: a network meta-analysis

Zhu,

He,

Xie

et al. 2024

Front. Immunol.

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Evaluation of Anti-Angiogenic Therapy Combined with Immunotherapy and Chemotherapy as a Strategy to Treat Locally Advanced and Metastatic Non-Small-Cell Lung Cancer

Abdallah,

Voland,

Decamp

et al. 2024

Cancers

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Immunotherapy has made recent improvements in disease-free survival (DFS) and/or overall survival (OS) in all stages of non-small-cell lung cancer (NSCLC). Here, we review the tumor microenvironment and its immunosuppressive effects and discuss how anti-angiogenic therapies may potentiate the anti-carcinogenic effects of immunotherapy. We also review all the past literature and discuss strategies of combining anti-angiogenic therapy and immunotherapy +/− chemotherapy and hypothesize how we can use this strategy for non-small-cell lung cancer in metastatic previously untreated/previously treated settings in previously treated EGFR-mutated NSCLC for the upfront treatment of brain metastases prior to radiation therapy and for the incorporation of this strategy into stage III unresectable disease. We assert the use of anti-angiogenic therapy and immunotherapy when combined appropriately with chemotherapy and radiotherapy has the potential to increase the long-term survivals in both the stage III and metastatic setting so that we can now consider more patients to experience curative treatment.

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Efficacy and safety of immune checkpoint inhibitors for individuals with advanced EGFR-mutated non-small-cell lung cancer who progressed on EGFR tyrosine-kinase inhibitors: a systematic review, meta-analysis, and network meta-analysis

Cited by 2 publications

References 72 publications

Efficacy and safety of immune checkpoint inhibitors for EGFR mutated non-small cell lung cancer: a network meta-analysis

Efficacy and safety of immune checkpoint inhibitors for EGFR mutated non-small cell lung cancer: a network meta-analysis

Evaluation of Anti-Angiogenic Therapy Combined with Immunotherapy and Chemotherapy as a Strategy to Treat Locally Advanced and Metastatic Non-Small-Cell Lung Cancer

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