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Anti-PD-1 versus anti-PD-L1 therapy in patients with pretreated advanced non-small-cell lung cancer: a meta-analysis

    Alfredo Tartarone

    *Author for correspondence: Tel.: +39 097 272 6111; Fax: +39 097 272 3509;

    E-mail Address: tarta1@virgilio.it

    Unit of Medical Oncology, Department of Onco-Hematology, IRCCS-CROB Referral Cancer Center of Basilicata Rionero in Vulture (PZ), Italy

    ,
    Giandomenico Roviello

    Department of Health Sciences, University of Florence, viale Pieraccini, 6, 50139, Florence, Italy

    ,
    Rosa Lerose

    Hospital Pharmacy, IRCCS-CROB Referral Cancer Center of Basilicata Rionero in Vulture (PZ), Italy

    ,
    Raheleh Roudi

    Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran

    ,
    Michele Aieta

    Unit of Medical Oncology, Department of Onco-Hematology, IRCCS-CROB Referral Cancer Center of Basilicata Rionero in Vulture (PZ), Italy

    &
    Pietro Zoppoli

    Laboratory of Preclinical & Translational Research, IRCCS-CROB Referral Cancer Center of Basilicata Rionero in Vulture (PZ), via Padre Pio 1, 85028, Italy

    Published Online:https://doi.org/10.2217/fon-2018-0868

    Aim: At present three immune checkpoint inhibitors (ICIs), two anti-PD-1 (nivolumab and pembrolizumab) and one anti-PD-L1 (atezolizumab) can be used in pretreated non-small-cell lung cancer patients. The aim of this meta-analysis is an indirect comparison between anti-PD-1 and anti-PD-L1 inhibitors. Methods: Seven studies (>4000 patients) were considered. Results: Considering the overall survival ICIs showed very robust efficacy over docetaxel, while in terms of progression-free survival the therapy with ICIs is slightly favored. Anti-PD-1 gives a more significant benefit than anti-PD-L1; however, excluding the KEYNOTE 010 trial that enrolled only PD-L1-positive patients, the subgroup difference remains only in terms of progression-free survival. Conclusion: This meta-analysis confirms the superiority of ICIs over docetaxel in pretreated non-small-cell lung cancer patients and would indicate a slight benefit from anti-PD-1 than from anti-PD-L1 inhibitors, always keeping in mind the possible biases of this indirect comparison.

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

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