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Lecai Xiong



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    P2.01 - Advanced NSCLC (ID 159)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Advanced NSCLC
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.01-101 - Multiple Chemotherapy-Based Combination Therapy Strategies for Advanced Lung Cancer Patients: A Systematic Review and Network Meta-Analysis (Now Available) (ID 1872)

      10:15 - 18:15  |  Author(s): Lecai Xiong

      • Abstract
      • Slides

      Background

      The treatments for patients with advanced lung cancer focus on chemotherapy, targeted therapy and immunotherapy, or a combination of multiple treatments. This study compares various chemotherapy-based combination therapies to identify the best one for patients with advanced lung cancer.

      Method

      A literature search was performed (PubMed, EMBASE and Medline) for randomized controlled trials of advanced lung cancer combination therapy from 2008 to 2018. Primary outcomes were overall survival (OS), progression-free survival (PFS), and objective response rate (ORR), adverse as second outcome indicators. A Bayesian mesh meta-analysis for multiple treatment strategies was implemented. The results of four outcome variables were combined to find the best chemotherapy-based combination therapy strategy.

      Result

      The analysis included 43 studies and five combination therapies: Chemotherapy/chemotherapy plus placebo (CT), CT plus one targeted therapy drug (CT+T), CT plus 2 targeted therapy drugs (CT+T+T), chemotherapy combined with immunotherapy (CT+IO) or chemotherapy combined with biotherapy (CT+B) (Figure 1 A-B). Hazard ratios for OS of CT+T, CT+T+T, CT+IO, CT+B compared to CT were 0.92 (CI 0.86, 0.97, p =0.0154), 0.90 (CI 0.74-1.1), 0.82 (CI 0.71-0.93, p =0.0069) and 1.1 (CI 0.77-1.5). And the HRs of CT+T+T, CT+IO compared to CT+T were 0.98 (CI 0.82-1.2), 0.89 (CI 0.77, 1.0). Finally, comparing with CT+T+T, CT+IO had longer survival 0.91 (CI 0.71-1.1). With the same tendency as PFS/ORR and OS (Figure 1 C-H), CT+IO showed the best therapeutic benefits, and its treatment-related adverse reaction rate was the lowest. Among immunotherapy drugs in these studies, pembrolizumab showed superior efficacy.

      Conclusion

      Among multiple chemotherapy-based combination therapy strategies, chemotherapy combined with immunotherapy is the best choice for patients with advanced lung cancer. Moreover, the results also showed that the PD-1 inhibitor (pembrolizumab) is superior to the CTLA4 inhibitor (ipilimumab).

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