Evidence map›Paper›PMID 30552160›Full record

SynthesisThe oncologist2019

Patient-Reported Outcomes with PD-1/PD-L1 Inhibitors for Advanced Cancer: A Meta-Analysis.

Tomohiro F Nishijima, Shlomit S Shachar, Hyman B Muss, Kazuo Tamura

Abstract readMeta-Analysis
In one paragraph

Synthesis in The oncologist, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 5 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

14 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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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

4 authors.

Tomohiro F NishijimaUNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA tomohiro_nishijima@med.unc.edu.ORCID 0000-0003-3773-7762
Shlomit S ShacharDivision of Oncology, Rambam Health Care Campus, Haifa, Israel.
Hyman B MussUNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA.
Kazuo TamuraGeneral Medical Research Center, Faculty of Medicine, Fukuoka University, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe aim of this meta-analysis was to compare patient-reported outcomes (PROs) between programmed death receptor-1/programmed death-ligand 1 (PD-1/PD-L1) inhibitors and standard-of-care therapy in patients with advanced cancer.

methodsWe searched randomized controlled trials (RCTs) comparing single-agent PD-1/PD-L1 inhibitors (nivolumab, pembrolizumab, atezolizumab, avelumab, or durvalumab) with standard-of-care therapy in patients with advanced cancer reporting PROs with generic measures: the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 items (QLQ-C30) and the EuroQol Five Dimensions Questionnaire. The summary outcomes were changes in PROs from baseline to follow-up within and between treatment groups and time to deterioration (TTD) in PROs based on clinically meaningful change.

resultsA total of 6,334 patients from 13 RCTs were included: six nivolumab, five pembrolizumab, and two atezolizumab trials. For the QLQ-C30 global health status/quality of life, the pooled difference in mean change between treatment groups was 5.1 (95% confidence interval [CI], 3.3-6.9;

conclusionPD1/PD-L1 inhibitors maintained health-related quality of life to a greater degree and had less worsening in symptoms than standard-of-care therapy even though patients on these immune modulators were on treatment longer. The better PRO profile further supports the clinical benefit of this treatment strategy for advanced cancer. IMPLICATIONS FOR PRACTICE: We conducted a systematic review and meta-analysis to compare patient-reported outcomes (PROs) of programmed death receptor-1/programmed death-ligand 1 (PD-1/PD-L1) inhibitors and standard-of-care therapy in patients with advanced cancer. PD-1/PD-L1 inhibitors were associated with consistently smaller PRO score deterioration from baseline to follow-up for different health-related quality-of-life and symptoms scales. In addition, the time to deterioration in multiple PRO domains was significantly longer with PD-1/PD-L1 inhibitors. Taken together, these findings indicate that the patients treated with PD-1/PD-L1 inhibitors maintained health-related quality of life to a greater degree and had less symptom burden compared with those treated with standard-of-care therapy.

Indexed as

Patient Reported Outcome MeasuresFemaleHumansImmunotherapyMaleProgrammed Cell Death 1 ReceptorProgrammed Cell Death 1 ReceptorHealth‐related quality of lifeMeta‐analysisPatient‐reported outcomesPD‐1/PD‐L1 inhibitorSymptoms

Identifiers

PMID30552160
PMCPMC6656437

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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.