KEY TAKEAWAYS
- The study aimed to investigate the optimal systemic treatment options for patients with NSCLC following the failure of ICIs.
- Researchers noticed that TKI + Chemo offers better PFS and ORR, ICI + TKI shows longest OS, and ICI + Antiangio-Ab has highest safety post-ICI failure in NSCLC.
Although immune checkpoint inhibitors (ICIs) have brought survival benefits to patients with non-small cell lung cancer (NSCLC), disease progression still occurs, and there is no consensus on the treatment options for these patients.
Kang Wang and the team designed a network meta-analysis (NMA) to evaluate systemic treatment options for NSCLC after failure of ICIs.
They performed an inclusive analysis by searching PubMed, Embase, Web of Science, and Cochrane Library databases followed by literature screening and NMA. Phase II and III randomized controlled trials (RCTs) were included, evaluating progression-free survival (PFS) and overall survival (OS) using hazard ratios (HRs), and objective response rate (ORR) and adverse events (AEs) using odds ratios (ORs) and relative risks (RRs) respectively. Bayesian NMA results were compared using R software.
About 1322 patients were included across 6 studies evaluating various treatments for patients with NSCLC post-ICI failure: ICI + Chemotherapy (Chemo), ICI + Anti-angiogenic monoclonal antibody (ICI + Antiangio-Ab), ICI + Tyrosine kinase inhibitor (ICI + TKI), TKI+ Chemo, Standard of Care (SOC), and Chemo alone. TKI + Chemo demonstrated longer PFS and a higher ORR (SUCRA 99.7%, 88.2%), while ICI + TKI achieved the longest OS (SUCRA 82.7%). ICI + Antiangio-Ab was associated with the highest safety ratings for AEs of any grade (SUCRA 95%), grade 3 or higher AEs (SUCRA 82%), and AEs leading to treatment discontinuation (SUCRA 93%).
The study concluded that TKI + Chemo offers superior PFS and higher ORR, ICI + TKI achieves the longest OS, and ICI + Antiangio-Ab demonstrates the highest safety profile for NSCLC following ICI failure.
The study received no funds.
Source: https://pubmed.ncbi.nlm.nih.gov/38937711/
Wang K, Fu Z, Sun G, et al. (2024). “Systemic treatment options for non-small cell lung cancer after failure of previous immune checkpoint inhibitors: a bayesian network meta-analysis based on randomized controlled trials.” BMC Immunol. 2024 Jun 28;25(1):37. doi: 10.1186/s12865-024-00633-z. PMID: 38937711; PMCID: PMC11212373.
