The efficacy and safety of anti-PD-1/PD-L1 antibody therapy versus docetaxel for pretreated advanced NSCLC: a meta-analysis

// Guanghong Huang 1, * , Xin Sun 1, * , Dapeng Liu 1 , Yunfeng Zhang 1 , Boxiang Zhang 1 , Guodong Xiao 1 , Xiang Li 1 , Xiao Gao 1 , Chenhao Hu 1 , Meng Wang 1 , Hong Ren 1 and Sida Qin 1 1 Department Two of Thoracic Surgery, The First Affiliated Hospital of Xi′an Jiaotong University, Xi′an, Shaanxi 710061, P.R. China * These authors contributed equally to this work Correspondence to: Sida Qin, email: sida.qin@yahoo.com Hong Ren, email: renhong@xjtu.edu.cn Keywords: NSCLC; PD-1/PD-L1; meta-analysis; Immune checkpoint inhibitor Received: July 08, 2017      Accepted: November 17, 2017      Published: December 15, 2017 ABSTRACT Antibodies against the immune checkpoint proteins PD-1 and PD-L1 are novel therapeutic drugs for the treatment of advanced non-small cell lung cancer (NSCLC). Many clinical trials involving these drugs achieved breakthroughs in patients previously treated for advanced NSCLC. However, the results of these clinical studies are not consistent. In this report, we performed a meta-analysis to assess the efficacy and safety of anti-PD-1/PD-L1 antibodies compared with docetaxel treatment for advanced NSCLC patients from 5 randomized clinical trials. We demonstrated that the patients in anti-PD-1/PD-L1 antibody therapy groups had significantly longer overall survival (OS) (HR = 0.69, 95% CI 0.63–0.75, P < 0.05) and progression-free survival (PFS) (HR = 0.76, 95% CI 0.63–0.92, P < 0.05) than those in chemotherapy groups, especially PD-L1 positive patients. Anti-PD-1/PD-L1 antibodies improved the objective response rate (ORR) compared with docetaxel (OR = 1.64, 95% CI 1.19–2.26, p < 0.05). In addition, the anti-PD-1/PD-L1 antibody therapy had fewer treatment-related adverse events (AEs) (OR = 0.33, 95% CI 0.28–0.39, P < 0.05) than docetaxel, especially the grade ≥3 AEs (OR = 0.18, 95% CI 0.12–0.28, P < 0.001). In conclusion, our study revealed that, compared with docetaxel, anti-PD-1/PD-L1 antibody therapy improved clinical efficacy and safety in previously treated advanced NSCLC patients. This therapy may be a promising treatment for advanced NSCLC patients.