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

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...

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Main Authors: Lin Zhu, Wenjuan He, Cunlei Xie, Yang Shu, Chunxia Zhang, Yawen Zhu
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2024.1512468/full
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author Lin Zhu
Wenjuan He
Cunlei Xie
Yang Shu
Chunxia Zhang
Yawen Zhu
author_facet Lin Zhu
Wenjuan He
Cunlei Xie
Yang Shu
Chunxia Zhang
Yawen Zhu
author_sort Lin Zhu
collection DOAJ
description 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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spelling doaj-art-236d506bb46b4635adcd2fd9516555522025-08-20T01:59:48ZengFrontiers Media S.A.Frontiers in Immunology1664-32242024-12-011510.3389/fimmu.2024.15124681512468Efficacy and safety of immune checkpoint inhibitors for EGFR mutated non-small cell lung cancer: a network meta-analysisLin Zhu0Wenjuan He1Cunlei Xie2Yang Shu3Chunxia Zhang4Yawen Zhu5Wuhan Wuchang Hospital, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, ChinaDepartment of Pharmacy, Wuhan Fourth Hospital, Wuhan, ChinaWuhan Wuchang Hospital, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, ChinaWuhan Wuchang Hospital, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, ChinaWuhan Wuchang Hospital, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, ChinaWuhan Wuchang Hospital, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, ChinaIntroductionNon-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.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1512468/fulltreatment strategyimmunotherapyoverall survivalprogression-free survivaladverse events
spellingShingle Lin Zhu
Wenjuan He
Cunlei Xie
Yang Shu
Chunxia Zhang
Yawen Zhu
Efficacy and safety of immune checkpoint inhibitors for EGFR mutated non-small cell lung cancer: a network meta-analysis
Frontiers in Immunology
treatment strategy
immunotherapy
overall survival
progression-free survival
adverse events
title Efficacy and safety of immune checkpoint inhibitors for EGFR mutated non-small cell lung cancer: a network meta-analysis
title_full Efficacy and safety of immune checkpoint inhibitors for EGFR mutated non-small cell lung cancer: a network meta-analysis
title_fullStr Efficacy and safety of immune checkpoint inhibitors for EGFR mutated non-small cell lung cancer: a network meta-analysis
title_full_unstemmed Efficacy and safety of immune checkpoint inhibitors for EGFR mutated non-small cell lung cancer: a network meta-analysis
title_short Efficacy and safety of immune checkpoint inhibitors for EGFR mutated non-small cell lung cancer: a network meta-analysis
title_sort efficacy and safety of immune checkpoint inhibitors for egfr mutated non small cell lung cancer a network meta analysis
topic treatment strategy
immunotherapy
overall survival
progression-free survival
adverse events
url https://www.frontiersin.org/articles/10.3389/fimmu.2024.1512468/full
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