Effects of Clinicopathological Characteristics on the Survival of Patients Treated with PD-1/PD-L1 Inhibitor Monotherapy or Combination Therapy for Advanced Cancer: A Systemic Review and Meta-Analysis
Background. PD-1/PD-L1 inhibitors have made unprecedented progress in the treatment of cancer. Methods. A systemic search was conducted for randomized controlled trials that compared PD-1/PD-L1 inhibitor monotherapy or combination therapy with nonimmunotherapy. Hazard ratios (HRs) of overall surviva...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Journal of Immunology Research |
| Online Access: | http://dx.doi.org/10.1155/2020/5269787 |
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| author | Yuhan Wei Yongfu Li Qi Du Xinyi Peng Jiangtao Jin Hong Guo Yongyan Li Qin Li |
| author_facet | Yuhan Wei Yongfu Li Qi Du Xinyi Peng Jiangtao Jin Hong Guo Yongyan Li Qin Li |
| author_sort | Yuhan Wei |
| collection | DOAJ |
| description | Background. PD-1/PD-L1 inhibitors have made unprecedented progress in the treatment of cancer. Methods. A systemic search was conducted for randomized controlled trials that compared PD-1/PD-L1 inhibitor monotherapy or combination therapy with nonimmunotherapy. Hazard ratios (HRs) of overall survival (OS) according to the sex, age, ECOG PS, smoking status, liver metastasis, PD-L1 expression, EGFR, and KRAS status of patients were analyzed. Results. Totally, 13 studies with monotherapy and 5 with combination regimens were included, and the pooled HRs of OS were 0.74 (P<0.001) and 0.64 (P<0.001), respectively. EGFR wild-type patients could benefit from immunotherapy monotherapy (HR, 0.77; P<0.001) while those of the mutant type had no survival benefit (HR, 1.11; P=0.54), and the difference was statistically significant (interaction, P=0.005). KRAS wild-type patients had no survival benefit from monotherapy (HR, 0.89; P=0.49). For combination therapy, both male and female derived benefits but female had a significantly reduced risk of death (HR, 0.45; P<0.001) compared with male (HR, 0.73; P<0.001; interaction, P=0.004). Nonsmokers derived more survival benefits from combination therapy (HR, 0.29; P<0.001) than smokers (HR, 0.63; P=0.001; interaction, P=0.02). No significant difference was found between age, ECOG PS, liver metastasis, PD-L1 expression, and OS of both PD-1/PD-L1 inhibitor monotherapy and combination therapy. Conclusions. Both PD-1/PD-L1 inhibitor monotherapy and combination therapy significantly prolonged the OS of patients with advanced malignant tumors. EGFR status for monotherapy and sex and smoking status for combination therapy were important predictors of survival benefits. |
| format | Article |
| id | doaj-art-9f8fad19a49e4ced88f3ff4515c999f3 |
| institution | Kabale University |
| issn | 2314-8861 2314-7156 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Immunology Research |
| spelling | doaj-art-9f8fad19a49e4ced88f3ff4515c999f32025-02-03T06:43:30ZengWileyJournal of Immunology Research2314-88612314-71562020-01-01202010.1155/2020/52697875269787Effects of Clinicopathological Characteristics on the Survival of Patients Treated with PD-1/PD-L1 Inhibitor Monotherapy or Combination Therapy for Advanced Cancer: A Systemic Review and Meta-AnalysisYuhan Wei0Yongfu Li1Qi Du2Xinyi Peng3Jiangtao Jin4Hong Guo5Yongyan Li6Qin Li7Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaDepartment of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaDepartment of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaDepartment of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, ChinaDepartment of Intervention Therapy, Zezhou People’s Hospital, Jincheng 048026, ChinaDepartment of Surgery, Beijing Changping District Hospital of Traditional Beijing Medicine, Beijing 102200, ChinaDepartment of Oncology, Beijing Pinggu Hospital, Beijing 101200, ChinaDepartment of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaBackground. PD-1/PD-L1 inhibitors have made unprecedented progress in the treatment of cancer. Methods. A systemic search was conducted for randomized controlled trials that compared PD-1/PD-L1 inhibitor monotherapy or combination therapy with nonimmunotherapy. Hazard ratios (HRs) of overall survival (OS) according to the sex, age, ECOG PS, smoking status, liver metastasis, PD-L1 expression, EGFR, and KRAS status of patients were analyzed. Results. Totally, 13 studies with monotherapy and 5 with combination regimens were included, and the pooled HRs of OS were 0.74 (P<0.001) and 0.64 (P<0.001), respectively. EGFR wild-type patients could benefit from immunotherapy monotherapy (HR, 0.77; P<0.001) while those of the mutant type had no survival benefit (HR, 1.11; P=0.54), and the difference was statistically significant (interaction, P=0.005). KRAS wild-type patients had no survival benefit from monotherapy (HR, 0.89; P=0.49). For combination therapy, both male and female derived benefits but female had a significantly reduced risk of death (HR, 0.45; P<0.001) compared with male (HR, 0.73; P<0.001; interaction, P=0.004). Nonsmokers derived more survival benefits from combination therapy (HR, 0.29; P<0.001) than smokers (HR, 0.63; P=0.001; interaction, P=0.02). No significant difference was found between age, ECOG PS, liver metastasis, PD-L1 expression, and OS of both PD-1/PD-L1 inhibitor monotherapy and combination therapy. Conclusions. Both PD-1/PD-L1 inhibitor monotherapy and combination therapy significantly prolonged the OS of patients with advanced malignant tumors. EGFR status for monotherapy and sex and smoking status for combination therapy were important predictors of survival benefits.http://dx.doi.org/10.1155/2020/5269787 |
| spellingShingle | Yuhan Wei Yongfu Li Qi Du Xinyi Peng Jiangtao Jin Hong Guo Yongyan Li Qin Li Effects of Clinicopathological Characteristics on the Survival of Patients Treated with PD-1/PD-L1 Inhibitor Monotherapy or Combination Therapy for Advanced Cancer: A Systemic Review and Meta-Analysis Journal of Immunology Research |
| title | Effects of Clinicopathological Characteristics on the Survival of Patients Treated with PD-1/PD-L1 Inhibitor Monotherapy or Combination Therapy for Advanced Cancer: A Systemic Review and Meta-Analysis |
| title_full | Effects of Clinicopathological Characteristics on the Survival of Patients Treated with PD-1/PD-L1 Inhibitor Monotherapy or Combination Therapy for Advanced Cancer: A Systemic Review and Meta-Analysis |
| title_fullStr | Effects of Clinicopathological Characteristics on the Survival of Patients Treated with PD-1/PD-L1 Inhibitor Monotherapy or Combination Therapy for Advanced Cancer: A Systemic Review and Meta-Analysis |
| title_full_unstemmed | Effects of Clinicopathological Characteristics on the Survival of Patients Treated with PD-1/PD-L1 Inhibitor Monotherapy or Combination Therapy for Advanced Cancer: A Systemic Review and Meta-Analysis |
| title_short | Effects of Clinicopathological Characteristics on the Survival of Patients Treated with PD-1/PD-L1 Inhibitor Monotherapy or Combination Therapy for Advanced Cancer: A Systemic Review and Meta-Analysis |
| title_sort | effects of clinicopathological characteristics on the survival of patients treated with pd 1 pd l1 inhibitor monotherapy or combination therapy for advanced cancer a systemic review and meta analysis |
| url | http://dx.doi.org/10.1155/2020/5269787 |
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