The Addition of Atezolizumab to Chemotherapy in Non-Small Cell Lung Cancer: A Trial-Based Review and Meta-Analysis.

IF 2.1 Q3 ONCOLOGY World Journal of Oncology Pub Date : 2024-02-01 Epub Date: 2023-12-09 DOI:10.14740/wjon1701
Nadya Keumala Fitri, Bahagia Willibrordus Maria Nainggolan, Naufal Nandita Firsty, Andika Pradana, Dina Keumala Sari
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引用次数: 0

Abstract

Background: Non-small cell lung cancer (NSCLC) stands as one of the most prevalent types of cancer worldwide, driving extensive research in oncologic therapeutic approaches. Atezolizumab, among the treatments under scrutiny, is undergoing evaluation as a potential first-line therapy for NSCLC. This review aims to assess the efficacy of atezolizumab in treating patients with NSCLC and to shed light on the ongoing quest for the most effective treatment.

Methods: Multiple scientific databases, including PubMed, Cochrane, and ScienceDirect, were consulted. The literature identification utilized the strategic Boolean term method of keywords relating to "non-small cell lung cancer" and "atezolizumab" to suggest the analyzed population in our review without restricting the potential outcomes. The primary inclusion criterion is clinical studies that attempted to determine the efficacy of atezolizumab in NSCLC patients.

Results: We included four trials to be analyzed in the final analysis, which we stratified into the programmed cell death-ligand 1 (PD-L1) expressivity status aside from the pooled intention-to-treat (ITT) population. We found the addition of atezolizumab may significantly improve the overall survival (OS) in the respective arm, remarkably among the high PD-L1 expression group (TC3 or IC3). The result of our meta-analysis presented the pooled OS of 0.79 (0.72, 0.87) in 95% confidence interval (CI) with a P value of < 0.05. Sub-analysis of the PD-L1's expression revealed TC3 population benefits the most (hazard ratio (HR): 0.55, 95% CI (0.42, 0.73)), compared to low (HR: 0.80, 95% CI (0.68, 0.93)) and negative expression (HR: 0.79, 95% CI (0.68, 0.93)); which is statistically meaningful (P < 0.05). Similar result was also observed in progression-free survival (PFS) analysis with the HR value of 0.63 (0.55, 0.72), with P value of < 0.05, favoring atezolizumab arm.

Conclusions: Upon examination, the study reveals that the addition of atezolizumab demonstrates notable improvements in both OS and PFS among NSCLC patients. These findings present promising attributes for atezolizumab as a viable treatment for NSCLC. However, it is important to acknowledge that the future holds further revelations in this realm, and more insights are yet to be uncovered.

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在非小细胞肺癌化疗中添加阿特珠单抗:基于试验的回顾与元分析》。
背景:非小细胞肺癌(NSCLC)是全球发病率最高的癌症类型之一,推动了肿瘤治疗方法的广泛研究。阿特珠单抗作为一种潜在的 NSCLC 一线疗法,正在接受评估。本综述旨在评估阿特珠单抗治疗NSCLC患者的疗效,并揭示目前对最有效治疗方法的探索:查阅了多个科学数据库,包括PubMed、Cochrane和ScienceDirect。文献识别使用了与 "非小细胞肺癌 "和 "atezolizumab "相关的关键词的策略布尔词法,以在不限制潜在结果的情况下提示我们综述的分析人群。主要纳入标准是试图确定阿特珠单抗对 NSCLC 患者疗效的临床研究:我们在最终分析中纳入了四项试验,除了汇总的意向治疗(ITT)人群外,我们还对这些试验进行了程序性细胞死亡配体1(PD-L1)表达状态分层。我们发现,添加阿特珠单抗可明显改善相应治疗组的总生存期(OS),尤其是在PD-L1高表达组(TC3或IC3)。我们的荟萃分析结果显示,在95%置信区间(CI)内,总生存率为0.79(0.72,0.87),P值小于0.05。对PD-L1表达的子分析显示,与低表达(HR:0.80,95% CI(0.68,0.93))和阴性表达(HR:0.79,95% CI(0.68,0.93))相比,TC3人群获益最大(危险比(HR):0.55,95% CI(0.42,0.73));这在统计学上是有意义的(P < 0.05)。在无进展生存期(PFS)分析中也观察到了类似的结果,HR值为0.63(0.55,0.72),P值<0.05,有利于阿特珠单抗治疗组:研究显示,在NSCLC患者中添加atezolizumab可显著改善OS和PFS。这些研究结果表明,atezolizumab 作为一种可行的 NSCLC 治疗方法具有良好的前景。然而,重要的是要承认,未来在这一领域会有更多的启示,更多的见解还有待发掘。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.10
自引率
15.40%
发文量
37
期刊介绍: World Journal of Oncology, bimonthly, publishes original contributions describing basic research and clinical investigation of cancer, on the cellular, molecular, prevention, diagnosis, therapy and prognosis aspects. The submissions can be basic research or clinical investigation oriented. This journal welcomes those submissions focused on the clinical trials of new treatment modalities for cancer, and those submissions focused on molecular or cellular research of the oncology pathogenesis. Case reports submitted for consideration of publication should explore either a novel genomic event/description or a new safety signal from an oncolytic agent. The areas of interested manuscripts are these disciplines: tumor immunology and immunotherapy; cancer molecular pharmacology and chemotherapy; drug sensitivity and resistance; cancer epidemiology; clinical trials; cancer pathology; radiobiology and radiation oncology; solid tumor oncology; hematological malignancies; surgical oncology; pediatric oncology; molecular oncology and cancer genes; gene therapy; cancer endocrinology; cancer metastasis; prevention and diagnosis of cancer; other cancer related subjects. The types of manuscripts accepted are original article, review, editorial, short communication, case report, letter to the editor, book review.
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