PD-L1 Inhibitors as monotherapy for the first-line treatment of non-small-cell lung cancer in PD-L1 positive patients: a safety data network meta-analysis

García-Campelo, Rosario; Arriola Aperribay, Edurne; Campos Balea, Begoña; López-Brea, Marta; Fuentes-Pradera, José; De Castro, Javier; Aguado, Carlos; Pérez Parente, Diego; de Oro Pulido, Fidel; Ruiz-Gracia, Pedro; Rodríguez-Abreu, Delvys

doi:http://dx.doi.org/10.3390/jcm10194583

PD-L1 Inhibitors as monotherapy for the first-line treatment of non-small-cell lung cancer in PD-L1 positive patients: a safety data network meta-analysis

License

Citation

García Campelo MR, Arriola E, Campos Balea B, López-Brea M, Fuentes-Pradera J, de Castro Carpeno J, et al. PD-L1 Inhibitors as monotherapy for the first-line treatment of non-small-cell lung cancer in PD-L1 positive patients: a safety data network meta-analysis. J Clin Med. 2021 Oct 4; 10(19): 4583. DOI: 10.3390/jcm10194583.

Abstract

This network meta-analysis (NMA) evaluates the safety of first-line programmed death-ligand 1 (PD-L1) inhibitor monotherapy in advanced NSCLC patients compared to platinum-based chemotherapy. We also compared the risk of adverse events (AEs) according to programmed cell death-1 receptor (PD-1) or PD-L1 inhibitors therapy. To that end, we conducted a series of metanalyses (MAs) using data from six phase III clinical trials, including 4053 patients. Our results show a reduced risk of any grade treatment-related AEs (risk ratio (RR) = 0.722 95% CI: 0.667-0.783, p = 0.002), and grade 3-5 AEs (RR = 0.406 95% CI: 0.340-0.485, p = 0.023) in immunotherapy as compared to chemotherapy. In contrast, a higher risk of immune-related AEs (irAEs) was estimated for immunotherapy versus chemotherapy. The subgroup MAs comparing PD-L1 to PD-1 inhibitors, determined a lower risk of AEs leading to treatment discontinuation in the anti-PD-L1 subgroup (RR = 0.47 95% CI: 0.29-0.75, p = 0.001); however, this statistically significant difference between anti-PD-L1 and anti-PD-1 subgroups was not reached for other safety outcomes analyzed. In conclusion, our findings show that PD-L1 inhibitor monotherapy improves safety outcomes in the 1L treatment of advanced NSCLC patients as compared to chemotherapy except for irAEs.