Anti-PD-1 therapy for clinical treatment of lymphoma: a single-arm meta-analysis
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Zhe Geng1, Yi Xiao1, Xiao-Jian Zhu1, Cong Ye2 and Jian-Feng Zhou1
1Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P. R. China
2Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P. R. China
Cong Ye, email: email@example.com
Jian-Feng Zhou, email: firstname.lastname@example.org
Keywords: Anti-PD1 antibodies; lymphoma; clinical activity; safety; meta-analysis
Received: October 13, 2017 Accepted: June 13, 2018 Published: October 19, 2018
Anti-PD1 antibodies exhibit satisfactory efficacy in treating certain types of lymphoma. We conducted this meta-analysis to explore subtypes benefiting from this treatment and the best anti-PD1 therapeutic modalities.
Methods: A quantitative meta-analysis was performed via a systematic search in PubMed, Web of Science, and The Cochrane Library. The pooled overall response rate (ORR), progression-free survival (PFS), complete remission rate (CRR), overall survival (OS) and adverse events (AEs) were calculated and compared. Data were analyzed using a random-effects meta-analysis to determine risk ratios. Heterogeneity across studies was analyzed using Q and I2 statistics.
Results: Thirteen articles were selected, and 9 studies were included in the meta-analysis. There was evidence of significant heterogeneity among the studies. According to PD-L1 expression subgroup analysis, the PD-L1-positive group exhibited significantly better outcomes than the PD-L1-negative group (Z=5.481, p=0.000), with pooled ORRs of 0.74 (95% CI: 0.67–0.81) and 0.2 (95% CI: 0.11–0.3), respectively. For PD-L1-positive and PD-L1-negative patients, the pooled CRRs, PFS and OS were 0.21 (95% CI: 0.14–0.29), 0.76 (95% CI: 0.71–0.81) and 1.0 (95% CI: 0.98–1.0) and 0.05 (95% CI: 0.01–0.11), 0.20 (95% CI: 0.09–0.39) and 0.64 (95% CI: 0.45–0.80), respectively; differences were all statistically significant (Z=2.248, p=0.025; Z=3.555, p=0.000; and Z=3.039, p=0.002, respectively). The pooled incidence of treatment-related all-grade AEs and grade-3/4 AEs was 0.84 (95% CI: 0.75–0.92) and 0.21 (95% CI: 0.15–0.29), respectively.
Conclusion: Patients with PD-L1 overexpression in relapsed or refractory lymphoma benefited more from anti-PD-1 therapy. Moreover, treatment with approved PD-1 inhibitors was well tolerated.
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