Predictors for Clinical Benefit of Immune Checkpoint Inhibitors in Advanced Non-Small-Cell Lung Cancer: A Meta-Analysis

Abstract

Aim: In this meta-analysis, we evaluated several predictors of benefit to single-agent immune checkpoint inhibitors (ICIs) in metastatic non-small-cell lung cancer (NSCLC). Patients & methods: Using the random-effect model, we assessed the comparative efficacy of ICIs over chemotherapy according to age, gender, smoking history, PD-L1 status and CNS involvement. Results: Eight randomized trials were selected. In comparison to chemotherapy, ICIs demonstrated significant progression-free survival (PFS) superiority in ever-smoker, male and PD-L1 positive subgroups. Never-smoker was an unfavorable factor for ICIs. Female and PD-L1 nonexpressing patients demonstrated similar PFS between ICIs and chemotherapy. ICI’s PFS benefit wasn’t influenced by age or CNS involvement. The overall survival (OS) benefit of ICIs was consistent across all subgroups, except for never-smokers. Conclusion: Male, ever-smoker and positive PD-L1 are indicative of benefit to ICIs in metastatic non-small-cell lung cancer.

Keywords::

• atezolizumab
• avelumab
• biomarker
• checkpoint inhibitors
• immunotherapy
• nivolumab
• non-small-cell lung cancer
• PD1/PDL1 inhibitor
• pembrolizumab

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of reasearch

The authors state that they have obtained appropriate institutional review board of approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.tandfonline.com/doi/suppl/10.2217/imt-2018-0086