First-Line Chemoimmunotherapy Versus Chemotherapy in PD-L1-Negative Patients with Non-Small-Cell Lung Cancer

Abstract

Background: In PD-L1-negative patients with advanced non-small-cell lung cancer (NSCLC), conclusive evidence in support of specific treatments remains lacking. Objectives: The efficacy of first-line chemoimmunotherapy versus chemotherapy alone was compared. Methods: Eligible randomized studies that included patients with advanced NSCLC irrespective of PD-L1 status who were treated with chemoimmunotherapy as the first line were identified. Kaplan-Meier curves were extracted and analyzed using restricted mean survival time (RMST). Patient-level data were reconstructed from progression-free survival (PFS) graphs. A Bayesian network meta-analysis (NETMA) was carried out. Results: In five trials selected, chemoimmunotherapy regimens, compared with chemotherapy alone, resulted in an improvement in PFS without statistical significance. In the NETMA, chemoimmunotherapy was found to slightly improve PFS. Conclusion: This analysis showed that the incremental benefit of chemoimmunotherapy versus chemotherapy is limited.

Keywords::

• chemoimmunotherapy
• network meta-analysis
• non-small-cell lung cancer
• PD-L1 negative
• restricted mean survival time

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-2021-0208

Author contributions

A Messori was responsible for study conception and design; L Cancanelli and D Mengato were responsible for the acquisition of data; M Rivano, L Cancanelli and D Mengato were responsible for data analysis and drafting; M Chiumente, L Di Spazio and A Messori were responsible for data quality assurance, revision of the manuscript and final approval of the version to be published.

Financial & competing interests disclosure

Marco Chiumente is a full-time employee of SIFACT. The authors have no other 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 apart from those disclosed.

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

Ethical conduct of research

The authors state that they have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations.