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. 2023 Apr 19:13:1137913.
doi: 10.3389/fonc.2023.1137913. eCollection 2023.

Prognostic influence of PD-1/PD-L1 suppressors in combination with chemotherapeutic agents for non-small cell pulmonary carcinoma: system review and meta-analysis

Min Shen  1 , Chunxia Lu  1 , Jie Gao  1
Affiliations

Prognostic influence of PD-1/PD-L1 suppressors in combination with chemotherapeutic agents for non-small cell pulmonary carcinoma: system review and meta-analysis

Min Shen et al. Front Oncol. .

Retraction in

Abstract

Background: Lung cancer is a common malignant tumor, which is seriously harmful to human life and health. Nowadays, it has gradually become one of the best treatments for non-small cell lung cancer (NSCLC) to combine immunotherapy and chemotherapy, and its clinical efficacy is preliminary. Nevertheless, substantial differences exist between various studies and various indicators. Despite their unconvincing results, high-quality research evidence is needed to support them. In this case, further correlative studies are necessary to investigate the prognostic outcomes of PD-1/PD-L1 suppressors in combination with chemotherapeutic drugs in NSCLC.

Methods: The online public databases were searchable for the clinical trials that consisted of NSCLC patients who had concluded their chemotherapy and who had accepted PD-1/PD-L1 suppressors. The time-span of the search spanned from the beginning to the end of the database. Two investigators retrieved the data independently. RevMan 5.3 statistical software was utilized for the assessment of bias risk. The software followed the Cochrane Handbook 5.3 guidelines.

Results: There were seven clinically controlled studies with 2781 NSCLC samples finally included in this study. A meta-analysis of the post-treatment overall response rate (ORR) was undertaken. A remarkably higher ORR rate was observed in the study group (p<0.05). Study participants had a noticeably longer PFS (HR=0.61, 95% CI=0.54-0.70, P<0.00001). Study participants had markedly longer overall survival (OS) (HR=0.651, 95% CI=0.52-0.82, P<0.05). The incidence of adverse events (AEs) of Grade 3 or above was not clinically clearly different (P>0.05), as demonstrated by the incidence of AEs. The funnel plots were separately charted in accordance with ORR rate, PFE, OS, and Grade 3 AEs. The majority of the funnel plots were symmetrical and a minority of funnel plots were asymmetrical, indicating the heterogeneity of research and the limited evidence available may lead to some publication bias in the contained literature.

Conclusion: The combined PD-1/PD-L1 inhibitors with conventional chemotherapy can dramatically elevate the prognosis of NSCLC patients, obviously enhancing the ORR rate and prolonging their PFS and OS. Furthermore, it was found that adding PD-1/PD-L1 inhibitors to conventional chemotherapy did not result in any additional adverse effects.

Keywords: NSCLC; PD-1/PD-L1 inhibitors; chemotherapeutic drugs; prognosis; short-term efficacy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
illustration of literature screening. Records identified from*: Refers to a database of literature sources. Records excluded**: Refers to excluded documents.
Figure 2
Figure 2
Risk bias chart.
Figure 3
Figure 3
Summary chart of risk bias.
Figure 4
Figure 4
Meta analysis forest map of CT+ICIs VS CT ORR rate.
Figure 5
Figure 5
Forest map of Meta analysis of PFS of CT+ICIs VS CT.
Figure 6
Figure 6
Total lifetime of CT+ICIs VS CT (OS) Meta analysis forest map.
Figure 7
Figure 7
Meta analysis forest map of AEs above CT+ICIs VS CT level 3.
Figure 8
Figure 8
Funnel chart based on ORR rate.
Figure 9
Figure 9
Funnel diagram based on PFS.
Figure 10
Figure 10
Funnel diagram based on OS.
Figure 11
Figure 11
Funnel chart based on level 3 and above Aes.
See this image and copyright information in PMC

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