Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

A Bayesian Network Meta-Analysis of First-Line Treatments for Non-Small Cell Lung Cancer with High Programmed Death-Ligand 1 Expression

Version 1 : Received: 28 December 2021 / Approved: 30 December 2021 / Online: 30 December 2021 (12:13:58 CET)

A peer-reviewed article of this Preprint also exists.

Kim, J.H.; Jeong, S.Y.; Lee, J.-J.; Park, S.T.; Kim, H.S. A Bayesian Network Meta-Analysis of First-Line Treatments for Non-Small Cell Lung Cancer with High Programmed Death Ligand-1 Expression. J. Clin. Med. 2022, 11, 1492. Kim, J.H.; Jeong, S.Y.; Lee, J.-J.; Park, S.T.; Kim, H.S. A Bayesian Network Meta-Analysis of First-Line Treatments for Non-Small Cell Lung Cancer with High Programmed Death Ligand-1 Expression. J. Clin. Med. 2022, 11, 1492.

Journal reference: J. Clin. Med. 2022, 11, 1492
DOI: 10.3390/jcm11061492

Abstract

We performed Bayesian network meta-analysis (NMA) to suggest frontline treatments for patients with high PD-L1 expression (at least 50%). A total of 5,237 patients from 22 studies were included in this NMA. In terms of progression-free survival, immune checkpoint inhibitors (ICIs) plus bevacizumab plus chemotherapy had the highest surface under the cumulative ranking curve (SUCRA) value (98.1%), followed by ICI plus chemotherapy (82.9%). In terms of overall survival (OS), dual immunotherapy plus chemotherapy had the highest SUCRA value (79.1%), followed by ICI plus bevacizumab plus chemotherapy (73.4%). However, there was no significant difference of survival outcomes among treatment regimens combined with immunotherapy. Moreover, ICI plus chemotherapy failed to reveal a significant OS superiority to ICI monotherapy (hazard ratio = 0.978, 95% credible internal: 0.771-1.259). In conclusion, this NMA indicates that ICI plus chemotherapy with/without bevacizumab might to be the best options in terms of OS for NSCLC with high PD-L1 expression. Considering there was no significant difference of survival outcomes among treatment regimens incorporating immunotherapy and ICI plus chemotherapy failed to show significant survival benefits over ICI monotherapy, however, ICI monotherapy may be reasonable as first-line treatment for advanced NSCLC with high PD-L1 expression and no targetable aberrations.

Keywords

non-small-cell lung cancer; immune checkpoint inhibitor; Bayesian meta-analysis; Review

Subject

MEDICINE & PHARMACOLOGY, Oncology & Oncogenics

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