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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Wednesday, July 10, 2024
It has been established that immune checkpoint inhibitor therapy is beneficial to patients with advanced non–small cell lung cancer (NSCLC). Yu et al, of Beijing Friendship Hospital, Capital Medical University, China, and colleagues conducted a study to determine the association between treatment regimens that include immune checkpoint inhibitors and survival in this patient population. The results of this study were published in The Clinical Respiratory Journal, although the investigators suggested additional data are necessary to validate their findings.
“Our analysis found that among advanced NSCLC patients with KRAS gene mutations, first-line treatment with pembrolizumab alone demonstrated greater efficacy,” concluded the researchers. “Similarly, second-line treatment with nivolumab alone was found to be more effective in this patient population.”
PubMed, Embase, Cochrane Library, and Web of Science were queried to find pertinent studies and conduct a comprehensive literature search. Data were collected and screened to establish a Bayesian framework. Primary endpoints included progression-free survival and overall survival; eligible studies included phase II and III randomized controlled trials that enrolled patients with histologically and cytologically confirmed metastatic or advanced NSCLC.
A total of six randomized controlled trials were included, comprising 469 patients with KRAS-mutated NSCLC. Of the total, 245 patients underwent treatment with immune checkpoint inhibitors ,and 224 received chemotherapy.
The addition of immune checkpoint inhibitors to chemotherapy was found to significantly improve both progression-free survival (hazard ratio [HR] = 0.69) and overall survival (HR = 0.57). Of note, pembrolizumab reportedly yielded the best improvement in overall survival (HR = 0.42) and was the most effective treatment for improving overall survival (surface under the cumulative ranking = 65.0%). Furthermore, the addition of pembrolizumab to chemotherapy demonstrated a significant improvement in progression-free survival (HR = 0.47).
Disclosure: The study authors reported no conflicts of interest.
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