Evidence map›Paper›PMID 30577837›Full record

SynthesisJournal for immunotherapy of cancer2018

Immune-checkpoint inhibitor plus chemotherapy versus conventional chemotherapy for first-line treatment in advanced non-small cell lung carcinoma: a systematic review and meta-analysis.

Yixin Zhou, Chen Chen, Xuanye Zhang, Sha Fu, Cong Xue, Yuxiang Ma, Wenfeng Fang, Yunpeng Yang, Xue Hou, Yan Huang and 3 more

Open access · goldAbstract 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 64 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
64citing papers in PubMed, 17 pooled it
5.1field-weighted citation impact, top 3% 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

64 citing papers in PubMed, 17 syntheses or guidelines pooled it, 99 citations in OpenAlex.

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  6. The optimal immune checkpoint inhibitors combined with chemotherapy for advanced non-small-cell lung cancer: a systematic review and meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2021
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  18. "What really works for us?" exploring therapeutic strategies for non-small cell lung cancer: an umbrella review of systematic reviews and meta-analyses.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
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4 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

13 authors at 1 institution in 1 country.

Yixin ZhouState Key Laboratory of Oncology in South China, Guangzhou, China.
Chen ChenState Key Laboratory of Oncology in South China, Guangzhou, China.
Xuanye ZhangState Key Laboratory of Oncology in South China, Guangzhou, China.
Sha FuGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Pathology Department, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Cong XueState Key Laboratory of Oncology in South China, Guangzhou, China.
Yuxiang MaState Key Laboratory of Oncology in South China, Guangzhou, China.
Wenfeng FangState Key Laboratory of Oncology in South China, Guangzhou, China.
Yunpeng YangState Key Laboratory of Oncology in South China, Guangzhou, China.
Xue HouState Key Laboratory of Oncology in South China, Guangzhou, China.
Yan HuangState Key Laboratory of Oncology in South China, Guangzhou, China.
Hongyun ZhaoState Key Laboratory of Oncology in South China, Guangzhou, China.
Shaodong HongState Key Laboratory of Oncology in South China, Guangzhou, China. hongshd@sysucc.org.cn.ORCID 0000-0002-5632-6857
Li ZhangState Key Laboratory of Oncology in South China, Guangzhou, China. zhangli6@mail.sysu.edu.cn.
Sun Yat-sen University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImmune-checkpoint inhibitors plus chemotherapy are emerging as effective first-line treatment in advanced non-small-cell lung carcinoma (NSCLC), but little is known about the magnitude of benefits and potential clinical predictors.

methodsWe performed a meta-analysis of randomized trials that compared PD-1/PD-L1 inhibitor plus chemotherapy with chemotherapy in first line of treatment for advanced NSCLC. The outcomes included progression-free survival (PFS), overall survival (OS), objective response rate (ORR) and treatment-related adverse events (AEs). A fixed-effect or random-effects model was adopted depending on between-study heterogeneity.

resultsSix trials involving 3144 patients were included. PD-1/PD-L1 inhibitor plus chemotherapy was significantly associated with improvement of PFS (hazards ratio [HR], 0.62; 95% CI 0.57-0.67; P < .001), OS (HR, 0.68; 95% CI 0.53-0.87; P = .002) and ORR (relative ratio [RR], 1.56; 95% CI 1.29-1.89; P < .001), irrespective of PD-L1 expression level. The significant predictor(s) for treatment benefit with combination therapy versus chemotherapy alone were PD-L1 expression level for PFS (P < .001); types of checkpoint inhibitor for ORR (P < .001); histology (P = .025), age (P = .038), gender (P < .001), and types of checkpoint inhibitor (P < .001) for OS. In safety analyses, PD-1/PD-L1 inhibitor plus chemotherapy had significantly higher incidence of adverse events (AEs) of grade 3 or higher (RR, 1.14; P = .007), AEs leading to treatment discontinuation (RR, 1.29; P = .022), serious AEs (RR 1.70; P = .006), immune mediated AEs of any grade (RR, 2.37; P < .001), and immune mediated AEs of grade 3 or higher (RR, 3.71; P < .001).

conclusionsPD-1/PD-L1 inhibitor plus chemotherapy, compared with chemotherapy, is associated with significantly improved PFS, ORR, and OS in first-line therapy in NSCLC, at the expense of increased treatment-related AEs.

Indexed as

Molecular Targeted TherapyAntineoplastic Agents, ImmunologicalAntineoplastic Combined Chemotherapy ProtocolsB7-H1 AntigenBiomarkers, TumorCarcinoma, Non-Small-Cell LungClinical Trials as TopicHumansLung NeoplasmsProgrammed Cell Death 1 ReceptorTreatment OutcomeAntineoplastic Agents, ImmunologicalB7-H1 AntigenBiomarkers, TumorCD274 protein, humanProgrammed Cell Death 1 ReceptorChemotherapyImmune checkpoint inhibitorNon-small cell lung carcinomaPredictProgrammed death 1Programmed death 1 ligand 1

Identifiers

PMID30577837
PMCPMC6303974
OpenAlexW2906250995

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

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.