NSCLC: meta-analysis supports sex-dependent effect for immunotherapy

  • Wang C & al.
  • Cancer Med
  • 4 Jun 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • The efficacy of immune checkpoint inhibitors (ICIs) for NSCLC is sex-dependent, with males having better outcomes with both programmed cell death 1/programmed cell death ligand 1 (PD-1/PD-L1) inhibitors, and females with a statistically significant benefit only with PD-1 inhibitors.

Why this matters

  • Studies on sex-based difference in ICI efficacy in NSCLC and other cancers have yielded conflicting results.

Study design

  • Meta-analysis of 15 RCTs of 9583 patients (6567 men; 3016 women) with advanced NSCLC and treated with ICIs.
  • Funding: National Natural Science Foundation of China.

Key results

  • Overall, both men and women had better OS (HR, 0.76; P<.001 and hr p=".007)" pfs ci with immunotherapy.>
  • Significant OS benefit with anti-PD‐1 in males and females (HR, 0.73; 95% CI, 0.67‐0.80 and HR, 0.69; 95% CI, 0.52‐0.93, respectively), but benefit with PD-L1 inhibitors was only significant in males (HR, 0.80; 95% CI, 0.69‐0.92).
  • Significant PFS benefit in males with PD‐1 and PD-L1 inhibitors (HR, 0.71; 95% CI, 0.58‐0.88 and HR, 0.64; 95% CI, 0.56‐0.74), but females had significant PFS improvement only with PD‐L1 inhibitors (HR, 0.56; 95% CI, 0.45‐0.69).

Limitations

  • Immature data from some studies.

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