Evidence map›Paper›PMID 30044785›Full record

SynthesisPloS one2018

Comparative efficacy and safety of licensed treatments for previously treated non-small cell lung cancer: A systematic review and network meta-analysis.

Xavier Armoiry, Alexander Tsertsvadze, Martin Connock, Pamela Royle, G J Melendez-Torres, Pierre-Jean Souquet, Aileen Clarke

Open access · goldAbstract readComparative StudyNetwork Meta-AnalysisSystematic Review
In one paragraph

Synthesis in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
2.0field-weighted citation impact, top 13% of its field
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

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Journal of cancer science and clinical therapeutics · 2022
    Article
  5. Article
  6. Article
  7. Immunotherapeutic Advances for NSCLC.Biologics : targets & therapy · 2021
    Review
  8. Immuno-oncology-the new paradigm of lung cancer treatment.Current oncology (Toronto, Ont.) · 2020
    Review
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

7 authors at 3 institutions in 3 countries.

Xavier ArmoiryUniversity of Warwick, Warwick Medical School, Division of Health Sciences, Coventry, England.ORCID 0000-0003-1166-0453
Alexander TsertsvadzeUniversity of Warwick, Warwick Medical School, Division of Health Sciences, Coventry, England.ORCID 0000-0003-3643-7813
Martin ConnockUniversity of Warwick, Warwick Medical School, Division of Health Sciences, Coventry, England.
Pamela RoyleUniversity of Warwick, Warwick Medical School, Division of Health Sciences, Coventry, England.
G J Melendez-TorresUniversity of Warwick, Warwick Medical School, Division of Health Sciences, Coventry, England.
Pierre-Jean SouquetHospices Civils de Lyon, Groupement hospitalier Sud, Service de Pneumologie oncologique, Pierre-Bénite, France.
Aileen ClarkeUniversity of Warwick, Warwick Medical School, Division of Health Sciences, Coventry, England.
University of Warwick · GBHospices Civils de Lyon · FRUniversity of Ottawa · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis systematic review with network meta-analysis compared the efficacy and safety of currently licensed second-line treatments in patients with late stage non-small cell lung cancer (NSCLC).

methodsRandomised controlled trials (RCTs) of participants with advanced/metastatic NSCLC receiving second/third line treatments were screened. We searched electronic databases (MEDLINE; EMBASE; Web of Science) from January, 2000 to July, 2017. Two reviewers screened bibliographic records, extracted data, and assessed risk of bias of included studies. The outcomes were overall survival (OS), progression-free survival (PFS), and drug-related grade 3-5 adverse-events (AEs). We pooled study-specific hazard ratios (HR; for OS and PFS) and risk ratios (RR; for AEs) using conventional and network-meta-analyses, and ranked interventions by the surface under the cumulative ranking curve.

findingsWe included 11 RCTs (7,581 participants) comparing nine drugs. All drugs except for erlotinib significantly improved OS compared to docetaxel. Nivolumab was the highest ranking drug followed by atezolizumab and pembrolizumab. There was no significant difference in OS across these three drugs (HR = 0.98, 95% CI 0.79, 1.21 for nivolumab vs atezolizumab; HR = 0.98, 95% CI 0.77, 1.25 for nivolumab vs pembrolizumab). For PFS, ramucirumab + docetaxel and nivolumab were the drugs with the highest ranking. All interventions except ramucirumab + docetaxel had a reduced risk for severe drug-related AEs vs. docetaxel. Of the drugs with the highest ranking on AEs, nivolumab was significantly safer compared to atezolizumab (RR = 0.55, 95% CI 0.38, 0.79) or pembrolizumab (RR = 0.52, 95% CI 0.34, 0.81). IMPLICATIONS: Nivolumab, pembrolizumab and atezolizumab exhibited superior benefit/risk balance compared to other licensed drugs used late stage NSCLC. Our results indicate that the use of immunotherapies in people diagnosed with non-specific late stage NSCLC should be promoted. The use of docetaxel may now be judged irrelevant as a comparator intervention for approval of new drugs for second line treatment of NSCLC. STUDY REGISTRATION NUMBER: PROSPERO CRD42017065928.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Non-Small-Cell LungLung NeoplasmsDisease ProgressionHumansProportional Hazards ModelsRetreatmentTreatment Outcome

Identifiers

PMID30044785
PMCPMC6059384
OpenAlexW2883058590

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.