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Checkpoint inhibitors in advanced nonsmall-cell lung cancer; a Bayesian network meta-analysis


1 Department of Medical Oncology, Medical Park Hospital, Antalya, Turkey
2 Department of Medical Oncology, Medical Park Hospital, Gaziantep, Turkey
3 Department of Internal Medicine, Sanko University School of Medicine, Gaziantep, Turkey
4 Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey

Correspondence Address:
Hakan Bozcuk,
Department of Medical Oncology, Medical Park Hospital, Lara, Antalya
Turkey
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.JCRT_450_19

Background: Checkpoint inhibitors (CPIs) have improved survival compared to chemotherapy alone in advanced nonsmall-cell lung cancer (NSCLC). This article aims to compare indirect evidence and rank the effect of different CPIs in this setting. Materials and Methods: In this network meta-analysis, we searched for trials comparing CPIs in advanced NSCLC. Figures for survival endpoints were extracted. In addition, a network meta-regression analysis was carried out. Results: A total of 9220 patients from 16 trials were included in the analysis. In the first-line setting, for the overall survival endpoint, the chemotherapy + Pembrolizumab combination had the highest effectivity rank probability as compared to chemotherapy (hazard ratio = 0.788, 95% credential interval = 0.728–0.855). For the second-line setting, and also for the efficacy in terms of progression-free survival, various CPIs and their combinations were ranked. Conclusion: Some degree of differences in terms of efficacy exists between different types, dosages, settings, and combinations of CPI. We quantify these differences to guide clinical practice.


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    -  Bozcuk H
    -  Yıldırım M
    -  Sever &
    -  Mutlu H
    -  Artaç M
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