Abstract 5364
Background
The value of combination therapy with immune checkpoint inhibitor (ICI) for patients with solid tumors remains unclear. Following the completion of several large phase III clinical trials, the role of combination ICI therapy in solid tumors should be redefined.
Methods
Pub-med, EMBASE, Cochrane Library and ClinicalTrials.gov website were searched for eligible randomized controlled trials (RCTs). The selection criteria were defined according to the PICO question: In patients with solid tumors (population), is there any difference of efficacy and safety (outcome) between combination ICI therapy (intervention) and traditional monotherapy (comparison)?
Results
17 RCTs with 6,616 patients were included in this meta-analysis. The combination therapy of ICI was signifcantly associated with improvement of overall response rate (ORR) (RR = 1.56 [95% CI 1.24, 1.96], P = 0.0001), progression free survival (PFS) (HR = 0.69 [95% CI 0.59, 0.81], P < 0.00001) and overall survival (OS) (HR = 0.76 [95% CI 0.67, 0.87], P < 0.0001) in solid tumor. In subgroup analyses, combination ICI therapy obviously prolonged OS in melanoma patients (HR = 0.64 [95% CI 0.57, 0.72], P < 0.00001), but not in SCLC (HR = 0.94 [95% CI 0.82, 1.08], P = 0.40) and NSCLC (HR = 0.92 [95% CI 0.79, 1.07], P = 0.26) patients. As for toxicity, there was an increased risk of fatigue, rash, diarrhoea and increased transaminases with combination ICI therapy.
Conclusions
In conclusion, our meta-analysis found that combination ICI therapy showed significant benefits in ORR, PFS and OS for patients with solid tumors. Both of combination of ICI with chemoradiotherapy and dual ICI were effective and relatively safe. Melanoma patients got definite survival benefit from combinaiton ICI therapy. Combination ICI therapy should be taken into account in clinical practice and future study designs for melanoma patients. There was also a tendency of improvement of survival for SCLC and NSCLC patients. However, the current data of our analyses didn’t support the large-scale clinical application of combination ICI therapy in NSCLC and SCLC patients. Furthermore, numerous RCTs assessing the efficacy and safety of combination therapy with ICI are ongoing.
Clinical trial identification
Legal entity responsible for the study
M. Peng.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
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