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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Frontiers Media S.A.
2024-12-01
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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 |
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| 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. |
| format | Article |
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| institution | OA Journals |
| issn | 1664-3224 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Immunology |
| 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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