SynthesisBMC cancer2025
First-line PD-1/PD-L1 inhibitors plus chemotherapy vs. chemotherapy alone in stage IIIB-IV non-squamous NSCLC: an updated meta-analysis of phase 3 RCTs.
Synthesis in BMC cancer, 2025. 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.
What it found
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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.
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.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Optimizing PD-1/PD-L1 inhibitors plus chemotherapy for driver mutation-negative non-squamous NSCLC in China: a cost-effectiveness analysis.Frontiers in pharmacology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPD-1/PD-L1 inhibitors combined with chemotherapy (PIC) has significantly reshaped treatment approaches in advanced non-small-cell lung cancer (NSCLC). However, whether PIC provides superior long-term efficacy compared to standard chemotherapy in advanced non-squamous NSCLC (nsqNSCLC) still requires comprehensive analysis using recent data from phase 3 randomized controlled trials (RCTs).
methodsRelevant studies comparing PIC with chemotherapy in stage IIIB-IV nsqNSCLC were identified through six databases. The key measures of interest were overall survival (OS) and progression-free survival (PFS), while additional endpoints encompassed tumor response and safety.
resultsTwelve multicenter phase 3 RCTs including 5,054 participants were analyzed. In comparison to chemotherapy alone, the PIC therapy resulted in significant improvements in both OS (HR: 0.73 [0.68-0.79], P < 0.00001) and PFS (HR: 0.59 [0.55-0.63], P < 0.00001). Survival benefits in both endpoints were consistently greater in the combination arm over a 6-60 month observation period. Stratified analysis revealed that the presence of brain metastases (OS, HR: 0.47; PFS, HR: 0.44) and a PD-L1 expression above 50% (OS, HR: 0.64; PFS, HR: 0.62) were predictive of enhanced efficacy for the combination strategy. Regarding treatment response, patients receiving PIC experienced a prolonged duration of response (HR: 0.57 [0.50-0.65], P < 0.00001) and a markedly increased objective response rate (RR: 1.69 [1.55-1.84], P < 0.00001). Nevertheless, both overall (RR: 1.95 [1.32, 2.87], P = 0.0007) and grade 3-5 immune-mediated adverse events (irAEs) (RR: 2.28 [1.64, 3.18], P < 0.00001) occurred more frequently in the PIC group.
conclusionsPIC therapy provides significant survival benefits and enhances anti-tumor efficacy in stage IIIB-IV nsqNSCLC, although it carries a higher toxicity burden, including both acute hematologic AEs and potentially chronic irAEs that require continuous clinical monitoring. PROSPERO REGISTRATION ID: CRD420251066166.
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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.