The efficacy and safety of anti-PD-1/PD-L1 antibody therapy versus docetaxel for pretreated advanced NSCLC: a meta-analysis

Guanghong Huang, Xin Sun, Dapeng Liu, Yunfeng Zhang, Boxiang Zhang, Guodong Xiao, Xiang Li, Xiao Gao, Chenhao Hu, Meng Wang, Hong Ren and Sida Qin _

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Oncotarget. 2018; 9:4239-4248. https://doi.org/10.18632/oncotarget.23279

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Guanghong Huang1,*, Xin Sun1,*, Dapeng Liu1, Yunfeng Zhang1, Boxiang Zhang1, Guodong Xiao1, Xiang Li1, Xiao Gao1, Chenhao Hu1, Meng Wang1, Hong Ren1 and Sida Qin1

1Department Two of Thoracic Surgery, The First Affiliated Hospital of Xi′an Jiaotong University, Xi′an, Shaanxi 710061, P.R. China

*These authors contributed equally to this work

Correspondence to:

Sida Qin, email: [email protected]

Hong Ren, email: [email protected]

Keywords: NSCLC; PD-1/PD-L1; meta-analysis; Immune checkpoint inhibitor

Received: July 08, 2017     Accepted: November 17, 2017     Published: December 15, 2017


Antibodies against the immune checkpoint proteins PD-1 and PD-L1 are novel therapeutic drugs for the treatment of advanced non-small cell lung cancer (NSCLC). Many clinical trials involving these drugs achieved breakthroughs in patients previously treated for advanced NSCLC. However, the results of these clinical studies are not consistent. In this report, we performed a meta-analysis to assess the efficacy and safety of anti-PD-1/PD-L1 antibodies compared with docetaxel treatment for advanced NSCLC patients from 5 randomized clinical trials. We demonstrated that the patients in anti-PD-1/PD-L1 antibody therapy groups had significantly longer overall survival (OS) (HR = 0.69, 95% CI 0.63–0.75, P < 0.05) and progression-free survival (PFS) (HR = 0.76, 95% CI 0.63–0.92, P < 0.05) than those in chemotherapy groups, especially PD-L1 positive patients. Anti-PD-1/PD-L1 antibodies improved the objective response rate (ORR) compared with docetaxel (OR = 1.64, 95% CI 1.19–2.26, p < 0.05). In addition, the anti-PD-1/PD-L1 antibody therapy had fewer treatment-related adverse events (AEs) (OR = 0.33, 95% CI 0.28–0.39, P < 0.05) than docetaxel, especially the grade ≥3 AEs (OR = 0.18, 95% CI 0.12–0.28, P < 0.001). In conclusion, our study revealed that, compared with docetaxel, anti-PD-1/PD-L1 antibody therapy improved clinical efficacy and safety in previously treated advanced NSCLC patients. This therapy may be a promising treatment for advanced NSCLC patients.

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