Advanced NSCLC: chemotherapy+ICIs boosts first-line efficacy

  • Lung Cancer

  • curated by Emily Willingham, PhD
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • In advanced NSCLC, the addition of chemotherapy to immune checkpoint inhibitors (ICIs), especially pembrolizumab or atezolizumab, boosts efficacy as first-line treatment.
  • Efficacy bump is most prominent with nonsquamous disease. 

Why this matters

  • The authors of this network meta-analysis (NMA) of 12 phase 3 studies say that the findings send a “very strong message” confirming evidence-based new standards of care for advanced NSCLC.

Key results

  • For OS; 10 studies with different combinations vs chemotherapy alone, pooled HRs (95% CIs):
    • Chemotherapy+pembrolizumab: pooled HR, 0.54 (0.46-0.64).
    • Chemotherapy+atezolizumab (with/without bevacizumab): 
      • NMA estimated HR, 0.75 (0.59-0.94);
      • Pooled HR, 0.85 (0.75-0.95).
    • Pembrolizumab monotherapy: HR, 0.81 (0.71-0.93).
  • NMA estimated pembrolizumab+chemotherapy as better than all other options: HRs, 0.51-0.72.
  • Analyses by histological subtype showed similar OS results favoring pembrolizumab+chemotherapy, as did analyses by PD-L1 status (≥50%,
  • PFS; primary outcome for the same groups/subsets largely also favored pembrolizumab or atezolizumab+chemotherapy.

Study design

  • NMA of published data from 12 clinical trials of ICIs with/without chemotherapy (15 published studies or presentations) including 9236 patients with NSCLC.
  • Funding: None. 

Limitations

  • NMAs involve some indirect comparisons and require cautious interpretation. 

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit