First‐line immune‐based combination therapies for advanced non‐small cell lung cancer: A Bayesian network meta‐analysis

Abstract

Background Immune‐based combination therapies have revolutionized the first‐line treatment for advanced non‐small cell lung cancer (NSCLC). However, for the efficacy and safety, the best treatment option is still uncertain. Methods We conducted a Bayesian network meta‐analysis of randomized controlled trials (RCTs) to evaluate first‐line immune‐based combination therapies for advanced NSCLC. Results Fourteen trials involving 8467 patients were included. For the programmed cell death‐ligand 1 (PD‐L1) expression non‐selective patients, there were no significant differences among all the treatment modes for overall survival (OS), but the ranking profiles indicated that Immunotherapy + Immunotherapy + Chemotherapy (IO + IO + Chemo) was most likely to be the best mode (probability = 68%). Immunotherapy + Immunotherapy + Anti‐angiogenic therapy + Chemotherapy (IO + Anti‐angio + Chemo) was significantly better than most other treatment modes for progression‐free survival (PFS) with better objective response rate (ORR) and more obvious grade ≥3 treatment‐related adverse events (TRAEs). In PD‐L1‐high cohort, IO + Anti‐angio + Chemo seemed to be the best mode for OS, PFS, and ORR according to the ranking profiles. In PD‐L1‐intermediate and PD‐L1‐negative cohort, IO + IO + Chemo was inclined to be ranked first for prolonging OS (probability = 78%; 37%) and IO + Anti‐angio + Chemo was most likely to provide best PFS (probability = 96%; 100%). Conclusion IO + IO + Chemo has great potential to improve the OS regardless of histology type, especially in PD‐L1‐intermediate and PD‐L1‐negative cohort. IO + Anti‐angio + Chemo shows great superiority in improving the short‐term survival accompanied by increasing grade ≥3 TRAEs.

Integration of artificial intelligence in lung cancer: Rise of the machine

“… 74 Several such studies have been performed in lung cancer, including evaluating safety and efficacy of bevacizumab biosimilars, 75 determining optimal platinum-based chemotherapy for early-stage resected NSCLC, 76 how smoking status influences effect of targeted therapy, 77 and choice of first-line treatment for patients on the basis of PD-L1 expression. 78 , 79 , 80 …”

Attempting to Identify Bacterial Allies in Immunotherapy of NSCLC Patients

“…Pembrolizumab with chemotherapy combined with paclitaxel or nab-paclitaxel could be used in squamous cell carcinoma patients. Moreover, combined treatment with nivolumab, ipilimumab, and limited chemotherapy (two cycles) finds application in the treatment of advanced NSCLC [ 9 ]. Chemoimmunotharpies result in improved PFS and OS regardless of PD-L1 expression or the presence of liver or brain metastases, although the lack of PD-L1 expression or the occurrence of metastases reduces the effectiveness of therapy [ 3 ].…”