Anti-PD-1/PD-L1 Therapy as a Promising Option for Non-Small Cell Lung Cancer: a Single arm Meta-Analysis

Pathol Oncol Res. 2016 Apr;22(2):331-9. doi: 10.1007/s12253-015-0011-z. Epub 2015 Nov 9.

Abstract

Anti-PD-1/PD-L1 antibodies showed satisfactory efficacy in treating non-small-cell lung cancer. We conducted this meta-analysis to explore the advantage subtypes and best therapeutic modalities of Anti-PD-1/PD-L1 therapy on NSCLC. A quantitative meta-analysis was performed through a systematic search in PubMed, Web of Science, and the Cochrane Library. The pooled ORR, 6-month progression-free survival rate (PFSR6m), and 1-year overall survival rate (OSR1y) were calculated and compared. 15 trials were included in this meta-analysis. Our analyses demonstrated the pooled ORR of 1st line and 2nd or more line anti-PD-1/PD-L1 therapy were 36.5% (21.9-51.0%) and 17.0% (14.3-19.7%), respectively. While the difference was significant (Z = 3.31, p < 0.001). The pooled ORR for non-squamous and squamous cell lung cancer were 18.5% (16.0-21.1%) and 17.9% (14.4-21.5%), respectively. The difference was not significant (Z = 0.27, p = 0.791). The pooled ORR for PD-L1 positive and negative patients were 29.6% (21.6-37.6%) and 13.5% (10.6-16.3%), respectively. The difference was significant (Z = 4.39, p < 0.001). The PFSR6m for PD-L1 positive and negative NSCLC were 50.0% (40.5-62.3%) and 27.0% (19.2-34.7%). The difference was significant (Z = 3.72, p < 0.001). The OSR1y for PD-L1 positive and negative NSCLC were 66.8% (44.8%-88.9%) and 54.0% (32.6-75.3%). The difference was not significant (Z = 0.77, p = 0.441). Anti-PD-1/PD-L1 antibody can serve as a promising treatment option for NSCLC. Patients with positive PD-L1 expression may benefit more from anti-PD-1/PD-L1 therapy. 1st-line anti-PD-1/PD-L1 therapy can be chosen as the best modality. Squamous cell lung cancer also benefit from anti-PD-1/PD-L1 therapy.

Keywords: Checkpoint inhibitor; Meta-analysis; Non-small cell lung cancer; PD-1; PD-L1.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • B7-H1 Antigen / antagonists & inhibitors*
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / metabolism
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / metabolism
  • Prognosis
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors*
  • Survival Rate

Substances

  • Antineoplastic Agents
  • B7-H1 Antigen
  • CD274 protein, human
  • PDCD1 protein, human
  • Programmed Cell Death 1 Receptor