PDF(Pubmed)
Abstract：
UNASSIGNED: Lung cancer is the leading cause of cancer-related death, and non-small-cell lung cancer (NSCLC) is the predominant subtype. Programmed death 1 (PD-1) and programmed death-ligand 1 (PD-L1) inhibitors are widely used to treat stage IV NSCLC. This study systematically reviewed the literature to clarify the impact of PD-1/PD-L1 inhibitor treatment on the survival of patients with stage III NSCLC.
UNASSIGNED: Randomized phase III clinical trials of PD-1/PD-L1 inhibitors administered to patients with stage III NSCLC that were written in English and published between November 2012 and November 2022 were eligible for review. The sources of information were the MEDLINE database (last consulted on December 26, 2022), ScienceDirect website (last consulted on December 26, 2022), and CENTRAL register (last consulted on December 27, 2022). The outcomes of interest were overall survival (OS), progression-free survival (PFS), disease-free survival (DFS), and event-free survival (EFS). Risk of bias assessments were performed according to the Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0. The findings have been assessed for certainty according to the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) guidelines.
UNASSIGNED: Fourteen eligible studies and 2788 participants were included in the review. The key characteristics used to group the participants were disease histology, percentage of PD-L1 expression in cancer cells, and timeline of therapy. OS and PFS were improved (risk ratio [RR]: 0.85; 95% confidence interval [CI]: 0.75-0.96 and RR: 0.75; 95% CI: 0.70-0.86, respectively) based on the use of PD-L1 inhibitors after chemoradiation and OS was improved using first-line PD-1 inhibitors plus chemotherapy in non-squamous NSCLC (RR: 0.40; 95% CI: 0.17-0.95), with the GRADE results indicating moderate quality of evidence.
UNASSIGNED: This review highlights the OS and PFS benefits of PD-L1 inhibitors in stage III NSCLC when used after chemoradiation and OS benefits of first-line PD-1 inhibitors added to chemotherapy in non-squamous stage III disease.
UNASSIGNED: Randomized phase III clinical trials of PD-1/PD-L1 inhibitors administered to patients with stage III NSCLC that were written in English and published between November 2012 and November 2022 were eligible for review. The sources of information were the MEDLINE database (last consulted on December 26, 2022), ScienceDirect website (last consulted on December 26, 2022), and CENTRAL register (last consulted on December 27, 2022). The outcomes of interest were overall survival (OS), progression-free survival (PFS), disease-free survival (DFS), and event-free survival (EFS). Risk of bias assessments were performed according to the Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0. The findings have been assessed for certainty according to the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) guidelines.
UNASSIGNED: Fourteen eligible studies and 2788 participants were included in the review. The key characteristics used to group the participants were disease histology, percentage of PD-L1 expression in cancer cells, and timeline of therapy. OS and PFS were improved (risk ratio [RR]: 0.85; 95% confidence interval [CI]: 0.75-0.96 and RR: 0.75; 95% CI: 0.70-0.86, respectively) based on the use of PD-L1 inhibitors after chemoradiation and OS was improved using first-line PD-1 inhibitors plus chemotherapy in non-squamous NSCLC (RR: 0.40; 95% CI: 0.17-0.95), with the GRADE results indicating moderate quality of evidence.
UNASSIGNED: This review highlights the OS and PFS benefits of PD-L1 inhibitors in stage III NSCLC when used after chemoradiation and OS benefits of first-line PD-1 inhibitors added to chemotherapy in non-squamous stage III disease.
摘要：
■肺癌是癌症相关死亡的主要原因，非小细胞肺癌（NSCLC）是主要亚型。程序性死亡1(PD-1)和程序性死亡配体1(PD-L1)抑制剂广泛用于治疗IV期NSCLC。本研究系统回顾文献,阐明PD-1/PD-L1抑制剂治疗对III期NSCLC患者生存的影响。
■对III期NSCLC患者给予PD-1/PD-L1抑制剂的随机III期临床试验以英文撰写，并在2012年11月至2022年11月之间发表，符合审查条件。信息来源是MEDLINE数据库（最后一次咨询于2022年12月26日），ScienceDirect网站（最后一次咨询于2022年12月26日），和中央登记册（最后一次咨询于2022年12月27日）。感兴趣的结果是总生存期(OS)，无进展生存期（PFS），无病生存率（DFS），和无事件生存（EFS）。根据Cochrane干预措施系统评价手册5.1.0版进行偏倚风险评估。根据建议分级，对调查结果进行了确定性评估，评估,发展,和评估（等级）指南。
■14项符合条件的研究和2788名参与者被纳入审查。用于对参与者进行分组的关键特征是疾病组织学，癌细胞中PD-L1表达的百分比，和治疗的时间表。根据放化疗后使用PD-L1抑制剂，OS和PFS得到改善（风险比[RR]：0.85；95％置信区间[CI]：0.75-0.96和RR：0.75；95％CI：0.70-0.86），并且在非鳞状NSCLC中使用一线PD-1抑制剂加化疗后OS得到改善（RR：0.40；95％CI：0.17-0.95），等级结果表明证据质量中等。
■本综述重点介绍了III期NSCLC中PD-L1抑制剂在放化疗后使用时的OS和PFS益处，以及非鳞状III期疾病化疗中添加一线PD-1抑制剂的OS益处。
■对III期NSCLC患者给予PD-1/PD-L1抑制剂的随机III期临床试验以英文撰写，并在2012年11月至2022年11月之间发表，符合审查条件。信息来源是MEDLINE数据库（最后一次咨询于2022年12月26日），ScienceDirect网站（最后一次咨询于2022年12月26日），和中央登记册（最后一次咨询于2022年12月27日）。感兴趣的结果是总生存期(OS)，无进展生存期（PFS），无病生存率（DFS），和无事件生存（EFS）。根据Cochrane干预措施系统评价手册5.1.0版进行偏倚风险评估。根据建议分级，对调查结果进行了确定性评估，评估,发展,和评估（等级）指南。
■14项符合条件的研究和2788名参与者被纳入审查。用于对参与者进行分组的关键特征是疾病组织学，癌细胞中PD-L1表达的百分比，和治疗的时间表。根据放化疗后使用PD-L1抑制剂，OS和PFS得到改善（风险比[RR]：0.85；95％置信区间[CI]：0.75-0.96和RR：0.75；95％CI：0.70-0.86），并且在非鳞状NSCLC中使用一线PD-1抑制剂加化疗后OS得到改善（RR：0.40；95％CI：0.17-0.95），等级结果表明证据质量中等。
■本综述重点介绍了III期NSCLC中PD-L1抑制剂在放化疗后使用时的OS和PFS益处，以及非鳞状III期疾病化疗中添加一线PD-1抑制剂的OS益处。
