Meta-Analysis

Frontline anti-PD-1/PD-L1 versus bevacizumab in advanced non-small-cell lung cancer: a network meta-analysis

Department of Radiation & Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

‡Authors contributed equally

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Xingyu Liu^‡

Department of Radiation & Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

‡Authors contributed equally

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Junhong Zhang

Department of Radiation & Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

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Zhao Huang

Department of Radiation & Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

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Wei Zeng

Department of Radiation & Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

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Jing Hu

Department of Radiation & Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

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Gang Chen

Department of Radiation & Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

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Yan Gong

https://orcid.org/0000-0002-4805-0459

Deparment of Biological Repositories, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

Tumor Precision Diagnosis & Treatment Technology & Translational Medicine, Hubei Engineering Research Center, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

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Yu Liu

*Author for correspondence: Tel.: +86 27 6781 2510;

E-mail Address: liuyu97@whu.edu.cn

Department of Radiation & Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

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Conghua Xie

**Author for correspondence: Tel.: +86 27 6781 2607;

E-mail Address: chxie_65@whu.edu.cn

https://orcid.org/0000-0001-6623-9864

Department of Radiation & Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China

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Published Online:7 Feb 2022https://doi.org/10.2217/fon-2021-0838

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Abstract

Aim: To review the efficacy and safety of regimens containing anti-PD-1/PD-L1 and bevacizumab for patients with advanced nonsquamous, non-small-cell lung cancer. Methods: Sixteen eligible trials were assessed. Clinical outcomes and adverse events were integrated. Subgroup analysis was conducted according to PD-L1 expression and liver metastases. Results: For the PD-L1 high population, a PD-1 inhibitor plus platinum-doublet provided significant progression-free survival (PFS) benefit versus bevacizumab. While for patients harboring PD-L1 <50%, anti-PD-1/PD-L1-containing regimens performed comparably to bevacizumab. With regard to the liver metastatic population, there existed a trend that anti-PD-1 plus chemotherapy brought about PFS benefits. Conclusion: The preference for chemoimmunotherapy lacks sufficient evidence in patients harboring PD-L1 <50%. Direct head-to-head clinical trials are warranted to identify optimal therapeutic regimens for specific patients.

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Papers of special note have been highlighted as: • of interest; •• of considerable interest

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Vol. 18, No. 13

Supplemental Materials

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History

Received 6 July 2021

Accepted 13 January 2022

Published online 7 February 2022

Published in print April 2022

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Keywords

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.futuremedicine.com/doi/suppl/10.2217/fon-2021-0838

Author contributions

Study conception and design were performed by C Xie & Y Liu. Data collection was performed by J Chen, X Liu, J Zhang, Z Huang, J Hu & G Chen. Analysis was performed by J Chen, W Zeng & Y Gong. The first draft of the manuscript was written by J Chen & X Liu and all authors approved the final submission.

Financial & competing interests disclosure

This study was supported by the National Natural Science Foundation of China (81773236, 81800429 and 81972852), Key Research & Development Project of Hubei Province (2020BCA069), Nature Science Foundation of Hubei Province (2020CFB612), Health Commission of Hubei Province Medical Leading Talent Project, Young and Middle-Aged Medical Backbone Talents of Wuhan (WHQG201902), Application Foundation Frontier Project of Wuhan (2020020601012221), Zhongnan Hospital of Wuhan University Science, Technology and Innovation Seed Fund (znpy2019001, znpy2019048, and ZNJC201922), and Chinese Society of Clinical Oncology Top Alliance Tumor Immune Research Fund (Y-JS2019-036). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

This study complied with the ethical principles of the Declaration of Helsinki and was approved by the Ethics Committee of Zhongnan Hospital of Wuhan University. The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Data sharing statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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