Gender associated differences in immune response are common. Latest clinical trials have proved the better overall survival (OS) for the use of immune checkpoint inhibitors (ICIs) verse chemotherapy in non-small cell lung cancer (NSCLC) patients. However, we still have no clear ideas of the efficacy of them in different gender. Therefore, we conducted a meta-analysis to compare the efficacy of ICIs for NSCLC patients of different gender groups and summarized overall treatment-related adverse events.
PubMed, EMBASE, Web of Science and the Cochrane Library were searched for all clinical trials in NSCLC until 28th of July 2019. Eligible studies included randomized controlled trials (RCTs) comparing ICIs with chemotherapy in NSCLC patients. The hazard ratio (HRs) and 95% confidence intervals (CIs) of OS, progression-free survival (PFS) or adverse events (AEs) were used.
A total of 5199 patients from 8 RCTs were included. ICIs significantly prolonged the OS (HR, 0.75; 95% CI, 0.67–0.84) and PFS (HR, 0.62; 95% CI, 0.47–0.83) versus chemotherapy in male NSCLC patients. Also, they prolonged the OS (HR, 0.62; 95% CI, 0.45–0.87) in female NSCLC patients. However, there was no statistical significance of PFS (HR, 0.64; 95% CI, 0.39–1.04) among female NSCLC patients. It also showed that the single use of ICIs had fewer all-grade AEs compared with the combination of ICIs and chemotherapy.
NSCLC patients could achieve better OS from ICIs than chemotherapy treatment regardless of their gender. But there was no significant difference in the PFS of female NSCLC patients. Male patients might be likely to get better results in the treatment of ICIs which needs to be further investigated.
Clinical trial identification
Legal entity responsible for the study
Capital’s Funds for Health Improvement and Research (No.2018-2-4065), National Natural Science Foundation of China (No. 81873396) and China-Japan Friendship Hospital.
All authors have declared no conflicts of interest.