Evaluation safety and efficacy of immune checkpoint blockers (ICB ) and radiotherapy combination versus ICB in non‐small cell lung cancer patients with recurrence or metastasis: A systematic review and meta‐analysis
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· 2023
· Open Access
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· DOI: https://doi.org/10.1002/cam4.5958
Background Currently, immune checkpoint blockers (ICB) and radiotherapy (RT) combination therapy is broadly applied in non‐small cell lung cancer (NSCLC) patients. However, meta‐analysis about safety and efficacy of RT + ICB versus ICB has not yet been reported. To evaluate safety and efficacy of the combination therapy of ICB and RT in patients with recurrent or metastatic NSCLC and explore factors related to higher response rates, longer lifetime, and lower toxicity, meta‐analysis of previous clinical data will be presented in this article. Methods A literature search on patients with recurrent or metastatic NSCLC treated with RT + ICB versus ICB was performed using the Cochrane Library, Embase and PubMed up to December 10, 2022. Suitable quality assessment checklists were selected corresponding to various types of research studies. Comparative and single‐arm studies were analyzed using Stata 14.0. Results 10 comparative studies and 15 arms of combination therapy were included for this meta‐analysis. RT significantly improved objective response rate (ORR), disease control rate (DCR), and overall survival (OS) and progression‐free survival (PFS) of ICB (I‐square value ( I 2 ) = 0.00%, odds ratio (OR) 1.28, 95% confidence interval (CI) 1.09–1.49, I 2 = 0.00%, OR 1.12, 95% CI 1.00–1.25, I 2 = 42.1%, OR 0.81, 95% CI 0.72–0.92, I 2 = 34.5%, OR 0.80, and 95% CI 0.71–0.89, respectively). Toxicity between combination therapy and ICB monotherapy did not significantly differ in any grade or in ≥3 grade of tr‐AEs ( I 2 = 0.00%, OR 1.05, 95% CI 0.91–1.22, I 2 = 0.00%, OR 1.46, 95% CI 0.90–2.37, respectively). Subgroup analyses based on single‐arm studies showed that applications of SRS/SBRT, PD‐1 inhibitor, and administration of ICB after RT were conducive to a better DCR, longer OS and mild adverse events (heterogeneity between groups (HBG) all p < 0.05). Conclusion RT can significantly improve ORR, DCR, OS, and PFS of ICB in patients with recurrent or metastatic NSCLC without increasing toxicity. PD‐1 inhibitor following SRS/SBRT could be the best option to maximally benefit the patients.
Related Topics
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1002/cam4.5958
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/cam4.5958
- OA Status
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- Cited By
- 4
- References
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- Related Works
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- OpenAlex ID
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Raw OpenAlex JSON
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https://openalex.org/W4380871513Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1002/cam4.5958Digital Object Identifier
- Title
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Evaluation safety and efficacy of immune checkpoint blockers (
ICB ) and radiotherapy combination versusICB in non‐small cell lung cancer patients with recurrence or metastasis: A systematic review and meta‐analysisWork title - Type
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reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
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2023Year of publication
- Publication date
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2023-06-16Full publication date if available
- Authors
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Yichun Zeng, Liying Zhang, Yichen Liang, Xian Zhang, Lei Li, Maoqi Wang, Jingliang Guo, Qiuxian Li, Cao Jin, Juan J. Gu, Buhai WangList of authors in order
- Landing page
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https://doi.org/10.1002/cam4.5958Publisher landing page
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/cam4.5958Direct link to full text PDF
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/cam4.5958Direct OA link when available
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Medicine, Internal medicine, Oncology, Lung cancer, Radiation therapy, Confidence interval, Meta-analysis, Combination therapy, Odds ratioTop concepts (fields/topics) attached by OpenAlex
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4Total citation count in OpenAlex
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2025: 1, 2024: 2, 2023: 1Per-year citation counts (last 5 years)
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45Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| corresponding_institution_ids | https://openalex.org/I191996457, https://openalex.org/I4210137355, https://openalex.org/I78978612 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.7200000286102295 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.81408474 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |