Evidence map›Paper›PMID 37737544›Full record

SynthesisCancer medicine2023

Disparity in survival benefits of pembrolizumab between Asian and non-Asian patients with advanced cancers: A systematic review and meta-regression analysis.

Shang-Hsuan Peng, Ching-Hung Lin, I-Chun Chen, Ying-Chun Shen, Dwan-Ying Chang, Tom Wei-Wu Chen, Shu-Min Huang, Fu-Chang Hu, Yen-Shen Lu

Open access · goldAbstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 23% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Article
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

9 authors at 2 institutions in 2 countries.

Shang-Hsuan PengDepartment of Oncology, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.ORCID 0000-0002-5260-9585
Ching-Hung LinDepartment of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan.ORCID 0000-0003-2403-4056
I-Chun ChenDepartment of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan.ORCID 0000-0001-9342-7596
Ying-Chun ShenDepartment of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan.
Dwan-Ying ChangDepartment of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
Tom Wei-Wu ChenDepartment of Oncology, National Taiwan University Hospital, Taipei, Taiwan.ORCID 0000-0003-4112-4029
Shu-Min HuangDepartment of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
Fu-Chang HuGraduate Institute of Clinical Medicine and School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.ORCID 0000-0002-9060-0506
Yen-Shen LuDepartment of Oncology, National Taiwan University Hospital, Taipei, Taiwan.ORCID 0000-0001-7461-1291
National Taiwan University Hospital · TWNational Taiwan University · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImmune checkpoint inhibitors have revolutionized the treatment of malignancies. However, disproportionate enrollment among races and ethnicities places the generalizability of global trial results in doubt.

methodsIn this systematic review, phase 3 randomized controlled trials investigating pembrolizumab in advanced cancers and providing subgroup analyses of Asian and non-Asian participants were included. The primary and secondary effect measures were the mean differences (MDs) in the natural logarithms of the hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) between these two subgroups, respectively. We used random-effects meta-analysis to calculate the pooled ratios of HRs (i.e., exp(MD)) and implemented a meta-regression analysis to identify significant covariates.

resultsA total of 17 and 11 trials were included in the meta-analyses of OS and PFS, respectively. These trials included 2732 (25.49%) Asian and 7000 (65.32%) non-Asian participants in the OS analysis and 1438 (22.5%) Asian and 4129 (64.61%) non-Asian participants in the PFS analysis. The pooled ratio of HRs for OS was 0.87 (95% CI: 0.76-0.99; p = 0.0391), favoring Asian participants, but no significant difference was found in PFS (pooled ratio of HRs: 0.93; 95% CI: 0.82-1.07; p = 0.2391). Both linear meta-regression analyses revealed an open-label design as a crucial covariate, which indicated more benefits for non-Asian participants.

conclusionsCompared with non-Asian patients, Asian patients with advanced cancers may derive superior OS benefits from pembrolizumab. Although the results warrant further exploration, this meta-analysis provides insight into clinical research design.

Indexed as

NeoplasmsAntibodies, Monoclonal, HumanizedHumansProportional Hazards ModelsRandomized Controlled Trials as TopicSurvival AnalysisAntibodies, Monoclonal, Humanizedpembrolizumabadvanced cancersAsianmeta-analysisoverall survivalpembrolizumab

Identifiers

PMID37737544
PMCPMC10587960
OpenAlexW4386945593

What OpenQuestion holds

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LicenceCC BY
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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.