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Thierry Landre
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Lunch & Poster Display session (ID 58)
- Event: ELCC 2019
- Type: Poster Display session
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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165P - Clinical benefit of anti PD-1/PD-L1 plus chemotherapy versus chemotherapy alone in first-line treatment in advanced non-small cell lung cancer: A meta-analysis (ID 383)
12:30 - 13:00 | Presenting Author(s): Thierry Landre
- Abstract
Background
First-line therapy for advanced non–small-cell lung cancer (NSCLC) that lacks targetable mutations is platinum-based chemotherapy. Combination of anti-PD-1/PD-L1 to chemotherapy (CT) offers a new therapeutic option for this population.
a9ded1e5ce5d75814730bb4caaf49419 Methods
We performed a meta-analysis of randomized trials that compared PD-1/PD-L1 inhibitor plus CT with CT alone in first line of treatment for advanced NSCLC. The outcomes included overall survival (OS), progression-free survival (PFS) and objective response rate (ORR). A fixed-effect or random-effects model was adopted depending on between-study heterogeneity.
20c51b5f4e9aeb5334c90ff072e6f928 Results
The eight eligible studies included 4401 patients (3097 males, mostly smokers (81%), median age 64 years), with 3037 nonsquamous (69 %) and 1330 squamous tumours (30%). One study evaluated nivolumab + CT (CheckMate 227), four studies evaluated atezolizumab + CT (IMpower 130,131,132 and 150), and three studies pembrolizumab + CT (Keynote 021, 189 and 407). The combination PD-1/PD-L1 inhibitor + CT was significantly associated with improvement of OS (hazards ratio [HR], 0.72; 95% CI 0.61–0.85; p < 0.0001), PFS (HR, 0.63; 95% CI 0.58–0.68; p < 0.0001) and ORR (relative ratio [RR], 2.08; 95% CI 1.69–2.55; p < 0.0001), irrespective of PD-L1 expression level. For patients with low (<1%) or undetectable PD-L1 expression, OS benefit was statistically significant (HR, 0.75; 95% CI 0.63-0.89; p < 0.0008).
fd69c5cf902969e6fb71d043085ddee6 Conclusions
The combination of PD-1/PD-L1 inhibitor to chemotherapy, compared with chemotherapy alone, is associated with significantly improved OS, PFS, and ORR in first-line therapy in NSCLC. This strategy appears as a new standard of care for patients with untreated NSCLC, including for those with low or undetectable PD-L1 expression.
b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study
APHP.
213f68309caaa4ccc14d5f99789640ad Funding
Has not received any funding.
682889d0a1d3b50267a69346a750433d Disclosure
All authors have declared no conflicts of interest.
cffcb1a185b2d7d5c44e9dc785b6bb25