Safety of PD-L1 inhibitors versus PD-1 inhibitors in the treatment of lung cancer: a systematic review and network meta-analysis.

IF 2.8 3区医学 Q2 ONCOLOGY Expert Review of Anticancer Therapy Pub Date : 2025-02-14 DOI:10.1080/14737140.2025.2465901

Jianqiao Ding, Zheyu Liu, Jing Ning, Nan Sun

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Abstract

Background: To explore the safety of PD-L1 inhibitors vs. PD-1 inhibitors in extensive-stage small-cell lung cancer (ES-SCLC) and non-small-cell lung cancer (NSCLC).

Research design and methods: PubMed, EMBASE, and the Cochrane Library were searched up to 20 December 2023. Randomized controlled trials on patients with NSCLC/ES-SCLC treated with PD-1/PD-L1 inhibitor were included and synthesized with Bayesian network meta-analysis.

Results: This meta-analysis included 58 studies. Regarding grade ≥3 treatment-related adverse events (TRAEs), PD-L1 inhibitors had better safety compared with PD-1 inhibitors when combined with chemotherapy in resectable NSCLC, presenting larger surface under the cumulative ranking (SUCRA) (0.577 vs. 0.168), similar with those in advanced NSCLC and ES-SCLC. The safety of PD-L1 inhibitors was better than PD-1 inhibitors regarding grade ≥3 pneumonia in resectable NSCLC when combined with chemotherapy (0.648 vs. 0.307), as well as in advanced NSCLC and ES-SCLC. When combined with chemotherapy, PD-L1 inhibitors had better safety regarding grade ≥3 pneumonitis, compared to PD-1 inhibitor (resectable NSCLC: 0.934 vs. 0.019; advanced NSCLC: 0.618 vs. 0.584; ES-SCLC: 0.505 vs 0.059).

Conclusion: PD-L1 inhibitors might be a safer option than PD-1 inhibitors regarding grade ≥3 TRAEs and pneumonia, monotherapy or combined with chemotherapy, and when combined with chemotherapy regarding grade ≥3 pneumonitis.

Registration: PROSPERO (CRD42024620372).

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PD-L1抑制剂与PD-1抑制剂治疗肺癌的安全性：系统综述和网络荟萃分析

背景：探讨PD-L1抑制剂与PD-1抑制剂在广泛期小细胞肺癌（ES-SCLC）和非小细胞肺癌（NSCLC）中的安全性。研究设计和方法：PubMed、EMBASE和Cochrane图书馆检索截止到2023年12月20日。纳入PD-1/PD-L1抑制剂治疗NSCLC/ES-SCLC患者的随机对照试验，并用贝叶斯网络meta分析进行综合。结果：本荟萃分析包括58项研究。对于≥3级的治疗相关不良事件（TRAEs）， PD-L1抑制剂与PD-1抑制剂联合化疗在可切除的NSCLC中具有更好的安全性，在累积排名（SUCRA）下呈现更大的表面（0.577比0.168），与晚期NSCLC和ES-SCLC相似。PD-L1抑制剂在可切除的非小细胞肺癌中联合化疗治疗≥3级肺炎的安全性优于PD-1抑制剂（0.648 vs. 0.307），以及在晚期非小细胞肺癌和ES-SCLC中的安全性。与化疗联合使用时，PD-L1抑制剂对≥3级肺炎的安全性优于PD-1抑制剂(可切除的NSCLC: 0.934 vs 0.019；晚期NSCLC: 0.618 vs 0.584；ES-SCLC: 0.505 vs 0.059)。结论：对于≥3级TRAEs和肺炎，单药或联合化疗，以及≥3级肺炎联合化疗，PD-L1抑制剂可能是比PD-1抑制剂更安全的选择。注册：普洛斯彼罗（CRD42024620372）。

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

Expert Review of Anticancer Therapy 医学-肿瘤学

CiteScore

5.10

自引率

3.00%

发文量

100

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anticancer Therapy (ISSN 1473-7140) provides expert appraisal and commentary on the major trends in cancer care and highlights the performance of new therapeutic and diagnostic approaches. Coverage includes tumor management, novel medicines, anticancer agents and chemotherapy, biological therapy, cancer vaccines, therapeutic indications, biomarkers and diagnostics, and treatment guidelines. All articles are subject to rigorous peer-review, and the journal makes an essential contribution to decision-making in cancer care. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.