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Comparative Study
. 2025 Mar:201:108450.
doi: 10.1016/j.lungcan.2025.108450. Epub 2025 Feb 17.

Comparative effectiveness and safety of tislelizumab versus other anti-PD-(L)1 agents in first- and subsequent lines in locally advanced or metastatic non-small cell lung cancer: Systematic literature review and network meta-analysis

Nicolas Girard  1 , Ji-Youn Han  2 , Ross A Soo  3 , Kaijun Wang  4 , Wenxi Tang  4 , Georgios F Nikolaidis  5 , Anastasios Tasoulas  6 , Ifigeneia Barouma  6 , JeanPierre Coaquira Castro  4 , Zheyuan Yang  5 , Tanushree Chaudhary  7 , Lin Zhan  4
Affiliations
Free article
Comparative Study

Comparative effectiveness and safety of tislelizumab versus other anti-PD-(L)1 agents in first- and subsequent lines in locally advanced or metastatic non-small cell lung cancer: Systematic literature review and network meta-analysis

Nicolas Girard et al. Lung Cancer. 2025 Mar.
Free article

Abstract

Objectives: To estimate the relative efficacy and safety of tislelizumab with or without chemotherapy in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) in first-line (1L) squamous, 1L non-squamous with programmed death-ligand 1 (PD-L1) ≥ 50 %, and second- and subsequent lines (2L + ) settings via indirect treatment comparisons, following a systematic literature review (SLR) of studies investigating existing anti-programmed cell death protein-(ligand)1 (PD-[L]1) therapies.

Methods: The SLR was originally conducted in 2022 and updated in 2023. A feasibility assessment (FA) was undertaken to assess the assumptions required for network meta-analysis (NMA) among therapies approved in the UK and European Union aligning with tislelizumab's license. Outcomes included overall survival (OS), progression-free survival (PFS), and grade ≥ 3 treatment-related adverse events (TRAEs). Analyses were conducted in the hazard ratio scale for OS and PFS and in the odds ratio scale for TRAEs. Uncertainty was expressed in 95 % credible intervals.

Results: The SLR identified 277 total studies in 1L and 176 in 2L + NSCLC, with 23 and eight carried forward to their respective FAs. After the FA stage, 20 and eight studies qualified for the 1L and 2L + NMAs, respectively. Tislelizumab with or without chemotherapy was statistically significantly more favorable than most comparator treatments and ranked as best or second-best treatment overall for the following: PFS in 1L squamous NSCLC, OS/PFS in 1L non-squamous NSCLC with PD-L1 ≥ 50 %, and OS/PFS/TRAEs in 2L + NSCLC of any histology. For the remaining analyses (i.e. OS/TRAEs in 1L squamous NSCLC), tislelizumab with or without chemotherapy was comparable to other anti-PD-(L)1 therapies and combination therapies.

Conclusions: Tislelizumab with or without chemotherapy appears to be comparable to or more favorable than other regimens of anti-PD-(L)1 therapies or combination therapies in OS/PFS/TRAEs across patients with 1L squamous NSCLC, 1L non-squamous NSCLC with PD-L1 ≥ 50 %, and 2L + NSCLC of any histology.

Keywords: Advanced lung cancer; Immunotherapies; Network meta-analysis; Overall survival; Progression-free survival.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: NG reports grants or contracts received from Abbvie, Amgen, AstraZeneca, BeiGene, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi-Sankyo, Gilead, Hoffmann-La Roche, Janssen, LeoPharma, Lilly, Merck Sharp & Dohme, Novartis, and Sivan; consulting fees received from Abbvie, Amgen, AstraZeneca, BeiGene, Bristol Myers Squibb, Daiichi-Sankyo, Gilead, Ipsen, Hoffmann-La Roche, Janssen, LeoPharma, Merck Sharp & Dohme, Mirati, Novartis, Pfizer, Sanofi, and Takeda; participation on a Data Safety Monitoring Board or Advisory Board for Hoffmann-La Roche; Employment of a family member at AstraZeneca. RAS reports research grants received from AstraZeneca, Boehringer Ingelheim, and Pfizer; Advisory Board consulting fees received from Abbvie, Amgen, AnHeart, AstraZeneca, Bayer, BMS, Boehringer Ingelheim, Daiichi Sankyo, GSK, J INTS BIO, Janssen, Lily, Merck, Merck Serono, Novartis, Pfizer, Puma, Roche, Sanofi, Taiho, Takeda, Thermo Fisher, and Yuhan Corporation; honoraria for lectures and presentations from Abbvie, Amgen, AnHeart, AstraZeneca, Bayer, BMS, Boehringer Ingelheim, Chugai, Daiichi Sankyo, GSK, J INTS BIO, Janssen, Lily, Merck, Merck Serono, Novartis, Pfizer, Puma, Roche, Sanofi, Taiho, Takeda, Thermo Fisher, and Yuhan Corporation. KW, JCC, and LZ are employees of BeiGene and may hold stock or other ownership. GFN, AT, IB, ZY, and TC are employees of IQVIA, a vendor contracted to develop methods, generate statistical models, support statistical analyses, and provide editorial assistance in the development of the manuscript on behalf of BeiGene. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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