Efficacy and safety of pembrolizumab for treating advanced non-small-cell lung cancer: a meta-analysis of phase II and III randomized controlled trials

Abstract

We conducted a meta-analysis to systematically review the efficacy and safety of pembrolizumab for advanced NSCLC. Databases were searched for randomized controlled trials (RCTs) treated with pembrolizumab till July 2021. Seven RCTs and 3988 patients were included. Our analysis suggests that pembrolizumab was more effective at improving PFS (HR, 0.59; 95% CI: 0.43–0.79; p = 0.0005), OS (HR, 0.65; 95% CI: 0.55–0.76; p ＜ 0.00001) and ORR (RR, 1.85; 95% CI: 1.64–2.09; p ＜ 0.00001) than chemotherapy. Patients with higher PD-L1 expression level were tend to have a better PFS, OS and ORR. Combination therapy of pembrolizumab was superior to pembrolizumab monotherapy in enhancing PFS. Pembrolizumab did not increase the frequency of commonly reported adverse events, but the immune-related adverse events (irAEs) occurred more frequently in the pembrolizumab group than those in the chemotherapy group. The pembrolizumab significantly improved the PFS, OS and ORR, simultaneously increasing the irAEs.

Keywords:

• Pembrolizumab
• advanced non-small-cell lung cancer
• efficacy
• safety
• meta-analysis

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.

Data accessibility

The data sets generated and/or analyzed during the current study are not publicly available. The authors are fully supportive of allowing independent assessment and verification of these results. Requests for data should be made via Email: [email protected].