Evidence map›Paper›PMID 29618381›Full record

SynthesisJournal for immunotherapy of cancer2018

Efficacy of PD-1 & PD-L1 inhibitors in older adults: a meta-analysis.

Rawad Elias, Anita Giobbie-Hurder, Nadine Jackson McCleary, Patrick Ott, F Stephen Hodi, Osama Rahma

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal for immunotherapy of cancer, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 124 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
124citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

124 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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  9. Patient performance status and cancer immunotherapy efficacy: a meta-analysis.Medical oncology (Northwood, London, England) · 2018
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64 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Rawad EliasSections of Hematology Oncology and geriatrics, Boston University School of Medicine, Boston, MA, USA.
Anita Giobbie-HurderDepartment of Biostatistics & Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA.
Nadine Jackson McClearyDepartment of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Patrick OttDepartment of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
F Stephen HodiDepartment of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Osama RahmaDepartment of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA. osamae_rahma@dfci.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImmune checkpoint inhibitors targeting PD-1/PD-L1 pathway demonstrated promising activities in variety of malignancies, however little is known regarding their efficacy in adults aged ≥65 years.

methodsWe conducted a systematic review and a study-level meta-analysis to explore efficacy of ICIs based on age, younger vs older than 65 years. We included in this analysis randomized controlled phase II or III studies in patients with metastatic solid tumors that compared efficacy of PD-1 or PD-L1 inhibitors to a non-PD-1/PD-L1 inhibitor. Aggregated estimates of overall survival (OS) and progression-free survival (PFS) are based on random/mixed effects (RE) models to allow for heterogeneity between the studies.

resultsInitial search identified 53 articles, 17 were randomized controlled trials that compared nivolumab, pembrolizumab or atezolizumab to chemotherapy or targeted therapy. Only 9 trials reported hazard ratiios (HR) for OS based on age and were included in this meta-analysis. Out of those studies seven reported HR for PFS but only 4 studies included subgroup-analysis based on age for PFS. The overall estimated random-effects HR for death was 0.64 with 95% CI of 0.54-0.76 in patients ≥65 years vs. 0.68 with 95% CI of 0.61-0.75 in patients < 65 years. The overall estimated random-effects for HR for progression was 0.74 with 95% CI of 0.60-0.92 in patients ≥65 years vs. 0.73 with 95% CI of 0.61-0.88 in patients < 65 years.

conclusionsPD-1 (nivolumab and pembrolizumab) and PD-L1 (atezolizumab) inhibitors had comparable efficacy in adults younger vs ≥ 65 years.

Indexed as

AgedAntineoplastic Agents, ImmunologicalB7-H1 AntigenClinical Trials, Phase II as TopicClinical Trials, Phase III as TopicHumansNeoplasmsProgrammed Cell Death 1 ReceptorRandomized Controlled Trials as TopicTreatment OutcomeAntineoplastic Agents, ImmunologicalB7-H1 AntigenCD274 protein, humanPDCD1 protein, humanProgrammed Cell Death 1 Receptor

Identifiers

PMID29618381
PMCPMC5885356

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.