Pembrolizumab plus chemotherapy for first-line treatment of metastatic nonsquamous non-small-cell lung cancer: A network meta-analysis

Andrew M. Frederickson; Stella Arndorfer; Ina Zhang; Maria Lorenzi; Ralph Insinga; Ashwini Arunachalam; Thomas A. Burke; George R. Simon

doi:10.2217/imt-2018-0193

Pembrolizumab plus chemotherapy for first-line treatment of metastatic nonsquamous non-small-cell lung cancer: A network meta-analysis

Andrew M. Frederickson, Stella Arndorfer, Ina Zhang, Maria Lorenzi, Ralph Insinga, Ashwini Arunachalam, Thomas A. Burke, George R. Simon

Thoracic Head & Neck Medical Oncology

Research output: Contribution to journal › Review article › peer-review

46 Scopus citations

Abstract

Aim: A systematic review and network meta-analysis were conducted to evaluate the efficacy of pembrolizumab + pemetrexed + platinum relative to other regimens in metastatic nonsquamous non-small-cell lung cancer (NSq-NSCLC). Patients & methods: Eligible studies evaluated first-line regimens in NSq-NSCLC patients without known targetable mutations. Relative treatment effects were synthesized with random effects proportional hazards Bayesian network meta-analyses. Results: The hazard ratio (HR) for overall survival (OS) for pembrolizumab + pemetrexed + platinum was statistically significant over all platinum-doublet (HR range: 0.42-0.61), platinum-doublet + bevacizumab (HR range: 0.44-0.53) and platinum-doublet + atezolizumab regimens (HR range: 0.56-0.62). Additionally, pembrolizumab + pemetrexed + platinum numerically improved OS over atezolizumab + paclitaxel + carboplatin + bevacizumab (HR: 0.65; 95% credible interval: 0.43, 1.01). Pembrolizumab + pemetrexed + platinum had 95.6% probability of being the best treatment regimen for OS. Conclusion: Pembrolizumab + pemetrexed + platinum is likely the most efficacious first-line regimen for metastatic NSq-NSCLC.

Original language	English (US)
Pages (from-to)	407-428
Number of pages	22
Journal	Immunotherapy
Volume	11
Issue number	5
DOIs	https://doi.org/10.2217/imt-2018-0193
State	Published - Apr 2019

Keywords

NSCLC
PD-L1 inhibitor
immunotherapy
nonsquamous
pembrolizumab

ASJC Scopus subject areas

Immunology and Allergy
Immunology
Oncology

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@article{cce9205d5b644d9fbfe8a6f044ffeac9,

title = "Pembrolizumab plus chemotherapy for first-line treatment of metastatic nonsquamous non-small-cell lung cancer: A network meta-analysis",

abstract = "Aim: A systematic review and network meta-analysis were conducted to evaluate the efficacy of pembrolizumab + pemetrexed + platinum relative to other regimens in metastatic nonsquamous non-small-cell lung cancer (NSq-NSCLC). Patients & methods: Eligible studies evaluated first-line regimens in NSq-NSCLC patients without known targetable mutations. Relative treatment effects were synthesized with random effects proportional hazards Bayesian network meta-analyses. Results: The hazard ratio (HR) for overall survival (OS) for pembrolizumab + pemetrexed + platinum was statistically significant over all platinum-doublet (HR range: 0.42-0.61), platinum-doublet + bevacizumab (HR range: 0.44-0.53) and platinum-doublet + atezolizumab regimens (HR range: 0.56-0.62). Additionally, pembrolizumab + pemetrexed + platinum numerically improved OS over atezolizumab + paclitaxel + carboplatin + bevacizumab (HR: 0.65; 95% credible interval: 0.43, 1.01). Pembrolizumab + pemetrexed + platinum had 95.6% probability of being the best treatment regimen for OS. Conclusion: Pembrolizumab + pemetrexed + platinum is likely the most efficacious first-line regimen for metastatic NSq-NSCLC.",

keywords = "NSCLC, PD-L1 inhibitor, immunotherapy, nonsquamous, pembrolizumab",

author = "Frederickson, {Andrew M.} and Stella Arndorfer and Ina Zhang and Maria Lorenzi and Ralph Insinga and Ashwini Arunachalam and Burke, {Thomas A.} and Simon, {George R.}",

note = "Funding Information: The research was funded by Merck & Co., Inc. Authors R Insinga, A Arunachalam and TA Burke are employees of Merck & Co., Inc. AM Frederickson, S Arndorfer, I Zhang and M Lorenzi are employees of Precision Xtract, a consultancy contracted by Merck & Co., Inc. to conduct research. GR Simon is a paid consultant to Merck & Co., Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Publisher Copyright: {\textcopyright} 2019 Andrew M Frederickson.",

year = "2019",

month = apr,

doi = "10.2217/imt-2018-0193",

language = "English (US)",

volume = "11",

pages = "407--428",

journal = "Immunotherapy",

issn = "1750-743X",

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TY - JOUR

T1 - Pembrolizumab plus chemotherapy for first-line treatment of metastatic nonsquamous non-small-cell lung cancer

T2 - A network meta-analysis

AU - Frederickson, Andrew M.

AU - Arndorfer, Stella

AU - Zhang, Ina

AU - Lorenzi, Maria

AU - Insinga, Ralph

AU - Arunachalam, Ashwini

AU - Burke, Thomas A.

AU - Simon, George R.

N1 - Funding Information: The research was funded by Merck & Co., Inc. Authors R Insinga, A Arunachalam and TA Burke are employees of Merck & Co., Inc. AM Frederickson, S Arndorfer, I Zhang and M Lorenzi are employees of Precision Xtract, a consultancy contracted by Merck & Co., Inc. to conduct research. GR Simon is a paid consultant to Merck & Co., Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Publisher Copyright: © 2019 Andrew M Frederickson.

PY - 2019/4

Y1 - 2019/4

N2 - Aim: A systematic review and network meta-analysis were conducted to evaluate the efficacy of pembrolizumab + pemetrexed + platinum relative to other regimens in metastatic nonsquamous non-small-cell lung cancer (NSq-NSCLC). Patients & methods: Eligible studies evaluated first-line regimens in NSq-NSCLC patients without known targetable mutations. Relative treatment effects were synthesized with random effects proportional hazards Bayesian network meta-analyses. Results: The hazard ratio (HR) for overall survival (OS) for pembrolizumab + pemetrexed + platinum was statistically significant over all platinum-doublet (HR range: 0.42-0.61), platinum-doublet + bevacizumab (HR range: 0.44-0.53) and platinum-doublet + atezolizumab regimens (HR range: 0.56-0.62). Additionally, pembrolizumab + pemetrexed + platinum numerically improved OS over atezolizumab + paclitaxel + carboplatin + bevacizumab (HR: 0.65; 95% credible interval: 0.43, 1.01). Pembrolizumab + pemetrexed + platinum had 95.6% probability of being the best treatment regimen for OS. Conclusion: Pembrolizumab + pemetrexed + platinum is likely the most efficacious first-line regimen for metastatic NSq-NSCLC.

AB - Aim: A systematic review and network meta-analysis were conducted to evaluate the efficacy of pembrolizumab + pemetrexed + platinum relative to other regimens in metastatic nonsquamous non-small-cell lung cancer (NSq-NSCLC). Patients & methods: Eligible studies evaluated first-line regimens in NSq-NSCLC patients without known targetable mutations. Relative treatment effects were synthesized with random effects proportional hazards Bayesian network meta-analyses. Results: The hazard ratio (HR) for overall survival (OS) for pembrolizumab + pemetrexed + platinum was statistically significant over all platinum-doublet (HR range: 0.42-0.61), platinum-doublet + bevacizumab (HR range: 0.44-0.53) and platinum-doublet + atezolizumab regimens (HR range: 0.56-0.62). Additionally, pembrolizumab + pemetrexed + platinum numerically improved OS over atezolizumab + paclitaxel + carboplatin + bevacizumab (HR: 0.65; 95% credible interval: 0.43, 1.01). Pembrolizumab + pemetrexed + platinum had 95.6% probability of being the best treatment regimen for OS. Conclusion: Pembrolizumab + pemetrexed + platinum is likely the most efficacious first-line regimen for metastatic NSq-NSCLC.

KW - NSCLC

KW - PD-L1 inhibitor

KW - immunotherapy

KW - nonsquamous

KW - pembrolizumab

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DO - 10.2217/imt-2018-0193

M3 - Review article

C2 - 30712477

AN - SCOPUS:85061988658

SN - 1750-743X

VL - 11

SP - 407

EP - 428

JO - Immunotherapy

JF - Immunotherapy

IS - 5

ER -

Pembrolizumab plus chemotherapy for first-line treatment of metastatic nonsquamous non-small-cell lung cancer: A network meta-analysis

Abstract

Keywords

ASJC Scopus subject areas

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