Non small cell lung cancer (NSCLC) comprises the majority of primary lung cancers and it is usually fatal in its advanced stages. the objective of this analysis is to assess the potential clinical and biological predictive markers of survival in pretreated advanced NSCLC patients treated with the three PD-1/PD-L1 inhibitors (nivolumab, pembrolizumab, atezolizumab).
MEDLINE and EMBASE databases have been searched. Randomized clinical trials comparing the three PD-1 /PD-L1 inhibitors versus other treatments for the management of Pretreated advanced NSCLC were evaluated.
Four randomized trials with 2163 were included. Two studies evaluated nivolumab versus docetaxel, one study evaluated pembrolizumab versus docetaxel and one study evaluated atezolizumab versus docetaxel. Comparing EGFR mutant to wild type disease, patients with EGFR wild type disease derive greater benefit from PD-1/PD-L1 inhibitors. The pooled HR for death for patients with mutant disease was 1.05 [95% CI: 0.69, 1.60; P= 0.81]; while pooled HR for death for patients with wild type disease was 0.66 [95% CI: 0.57, 0.77; P
Further controlled studies are required to properly confirm the predictive value of PD-L1 and EGFR statuses in this setting as well as evaluate more clearly the predictive role of smoking, KRAS status, ALK status and CNS metastasis.
Clinical trial identification
Legal entity responsible for the study
Ain Shams University
All authors have declared no conflicts of interest.