KEY TAKEAWAYS
- The study aimed to investigate the comparative efficacy and safety of different immunotherapy types for patients with NSCLC with BMs.
- Researchers noticed that pembrolizumab is the top choice for NSCLC with BMs, and nivolumab+ipilimumab is an alternative.
Growing evidence suggests that immunotherapy has a positive effect on patients with non-small cell lung cancer (NSCLC) with brain metastases (BMs). However, it remains unclear which type of immunotherapy is more efficient.
Tianyi Lyu and the team aimed to assess the network meta-analysis (NMA) to compare the efficacy and safety of different immunotherapy types and determine the optimal option.
They performed an inclusive analysis by searching 4 databases (PubMed, Cochrane Library, Embase, and Web of Science) and ClinicalTrials.gov from inception until January 26, 2023. They included randomized controlled trials (RCTs), prospective nonrandomized trials, and observational studies investigating patients with NSCLC having BMs treated with immunotherapy.
The quality of the included studies was assessed using the Cochrane risk of bias (ROB) tool and the Newcastle-Ottawa Scale (NOS). The efficacy of immunotherapy on patients with NSCLC and BMs was evaluated using a frequentist random-effects NMA.
The results of the analysis included 11 studies with 1,437 participants from a total of 1,560 citations. The findings indicated that pembrolizumab (SMD = 4.35, 95% CI [2.21, 6.60]) and the combination of nivolumab with ipilimumab (SMD = 3.81, 95% CI [1.21, 6.40]) were effective in improving overall survival (OS) for patients with NSCLC and BMs.
Pembrolizumab (SMD = 3.32, 95% CI [2.75, 3.90]) also showed superior results in enhancing the overall response rate (ORR) compared to other treatments. Additionally, there was no significant difference in adverse events (AEs) between immunotherapy and chemotherapy.
The study concluded that pembrolizumab was the most promising immunotherapy for patients with NSCLC and BMs, with nivolumab+ipilimumab being a potential alternative for improving OS.
This study was funded by the National High-Level Hospital Clinical Research Funding (2023-NHLHCRF-YYPPLC-TJ-01), Elite Medical Professionals Project of China-Japan Friendship Hospital (No. ZRJY2021-GG06) and the Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine (No. ZYYCXTD-D-202208).
Source: https://pubmed.ncbi.nlm.nih.gov/39161997/
Lyu T, Sun B, Yang D, et al. (2024). “Comparative Efficacy and Safety of Immunotherapy on Non-Small Cell Lung Cancer Patients With Brain Metastases: A Systematic Review and Network Meta-Analysis.” Clin Respir J. 2024 Aug;18(8):e13823. doi: 10.1111/crj.13823. PMID: 39161997; PMCID: PMC11333852.
