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Meta-Analysis
. 2020 Jun 26;9(1):1781333.
doi: 10.1080/2162402X.2020.1781333.

A meta-analysis comparing responses of Asian versus non-Asian cancer patients to PD-1 and PD-L1 inhibitor-based therapy

Ling Peng  1 , Bao-Dong Qin  2 , Kui Xiao  3 , Song Xu  4 , Jin-Song Yang  1 , Yuan-Sheng Zang  2 , Justin Stebbing  5 , Li-Ping Xie  6
Affiliations
Meta-Analysis

A meta-analysis comparing responses of Asian versus non-Asian cancer patients to PD-1 and PD-L1 inhibitor-based therapy

Ling Peng et al. Oncoimmunology. .

Abstract

Background: Subgroup analysis of clinical trials of PD-1/PD-L1 inhibitors have reported ethnic differences in outcomes. We systematically collected published data and performed a meta-analysis to compare therapeutic efficacy in Asian and non-Asian patients receiving PD-1/PD-L1 inhibitors.

Methods: Eligible studies included phase II and III prospective clinical trials with available subgroup data on Asian versus non-Asian populations. Overall survival (OS) and progression-free survival (PFS) were used to evaluate differences in outcome between Asian versus non-Asian cancer patients.

Results: A total of 11,020 cancer patients from 19 prospective randomized controlled clinical trials were included. The overall estimated HR for OS was 0.69 with 95% CI of 0.61-0.77 in Asian versus 0.82 with 95% CI of 0.77-0.88 in non-Asian patients. The estimated hazard ratio (HR) for PFS measured 0.54 (95% CI, 0.32-0.76) and 0.69 (95% CI, 0.54-0.85) in Asian and non-Asian patients, respectively. Pooled ratios of OS HRs and PFS HRs reported in Asian versus non-Asian cancer patients were 0.84 (95% CI, 0.75-0.94) and 0.78 (95% CI, 0.59-0.97), respectively.

Conclusions: This meta-analysis shows for the first time that Asian cancer patients have a significantly improved survival benefit than non-Asian patients receiving PD-1/PD-L1 inhibitor-based therapy.

Keywords: Ethnic; cancer; immune checkpoint inhibitor; meta-analysis.

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Conflict of interest statement

JS’ conflicts can be found at: https://www.nature.com/onc/editors. None are relevant here. No other author declares a conflict.

Figures

Figure 1.
Figure 1.
Selection process for the trials included in the meta-analysis.
Figure 2.
Figure 2.
Hazard ratios of OS in patients receiving PD-1/PD-L1 inhibitor-based therapy versus control in the overall population, Asian and non-Asian patients.
Figure 3.
Figure 3.
Hazard ratios of PFS in patients receiving PD-1/PD-L1 inhibitor-based therapy versus control in the overall population, Asian and non-Asian patients.
Figure 4.
Figure 4.
Ratio of OS HR (a) and PFS HR (b) between Asian and non-Asian cancer patients. Ratio of OS HR subgroup analysis of tumor type (c) and PD-1/PD-L1 drug (d).
Figure 5.
Figure 5.
Sensitivity analysis. (a) Sensitivity analysis of HR ratios of OS; (b) Sensitivity analysis of HR ratio of PFS.
Figure 6.
Figure 6.
Publication bias. (a) Begg’s funnel plot of HR ratios of OS; (b) Begg’s funnel plot of HR ratio of PFS.
See this image and copyright information in PMC

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