Sex-based differences in effectiveness of immune checkpoint inhibitors in the treatment of advanced non-small-cell lung cancer: systematic review and meta-analysis.
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OpenAlex 토픽 ·
Cancer Immunotherapy and Biomarkers
Lung Cancer Treatments and Mutations
Ferroptosis and cancer prognosis
[BACKGROUND] Sex-based differences in immune response are well established, but whether men and women derive comparable benefit from immune checkpoint inhibitors (ICIs) in advanced non-small cell lung
- p-value p=0.005
- p-value p=0.043
- 95% CI 0.72 to 0.78
- HR 0.75
- 연구 설계 systematic review
APA
Erick Suazo-Zepeda, Grietje G Talen, et al. (2026). Sex-based differences in effectiveness of immune checkpoint inhibitors in the treatment of advanced non-small-cell lung cancer: systematic review and meta-analysis.. Thorax. https://doi.org/10.1136/thorax-2025-223372
MLA
Erick Suazo-Zepeda, et al.. "Sex-based differences in effectiveness of immune checkpoint inhibitors in the treatment of advanced non-small-cell lung cancer: systematic review and meta-analysis.." Thorax, 2026.
PMID
41997852
Abstract
[BACKGROUND] Sex-based differences in immune response are well established, but whether men and women derive comparable benefit from immune checkpoint inhibitors (ICIs) in advanced non-small cell lung cancer (NSCLC) remains uncertain. This systematic review and meta-analysis aimed to investigate sex-related differences in effectiveness of ICI for the treatment of advanced NSCLC.
[METHODS] A systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted to compare overall survival (OS) and progression-free survival (PFS) between men and women treated with ICIs versus chemotherapy for stage III-IV NSCLC. Eligible studies compared programmed cell death protein 1/programmed cell death ligand 1 (PD-L1) inhibitors with chemotherapy and reported sex-specific OS and/or PFS outcomes. HRs were pooled using random-effects models, and secondary analyses incorporated updated follow-up data where available.
[RESULTS] 55 RCTs comprising 28 550 adults (71.6% men; 28.4% women) were included. ICIs significantly improved OS in both men (HR=0.75, 95% CI 0.72 to 0.78) and women (HR=0.81, 95% CI 0.76 to 0.86; p=0.17 for difference). However, PFS benefits favoured men (HR=0.62, 95% CI 0.59 to 0.65) compared with women (HR=0.76, 95% CI 0.70 to 0.81; p=0.005). In analyses using the most recent follow-up data, women showed lower ICI effectiveness for both OS (p=0.043) and PFS (p=0.003).
[CONCLUSIONS] ICIs confer similar OS benefits in men and women with advanced NSCLC, but women show shorter PFS, particularly in PD-L1-positive and monotherapy settings. Further research should clarify the biological and clinical factors underlying these differences and ensure balanced representation and equitable evaluation in future trials.
[PROSPERO REGISTRATION NUMBER] CRD42024451670.
[METHODS] A systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted to compare overall survival (OS) and progression-free survival (PFS) between men and women treated with ICIs versus chemotherapy for stage III-IV NSCLC. Eligible studies compared programmed cell death protein 1/programmed cell death ligand 1 (PD-L1) inhibitors with chemotherapy and reported sex-specific OS and/or PFS outcomes. HRs were pooled using random-effects models, and secondary analyses incorporated updated follow-up data where available.
[RESULTS] 55 RCTs comprising 28 550 adults (71.6% men; 28.4% women) were included. ICIs significantly improved OS in both men (HR=0.75, 95% CI 0.72 to 0.78) and women (HR=0.81, 95% CI 0.76 to 0.86; p=0.17 for difference). However, PFS benefits favoured men (HR=0.62, 95% CI 0.59 to 0.65) compared with women (HR=0.76, 95% CI 0.70 to 0.81; p=0.005). In analyses using the most recent follow-up data, women showed lower ICI effectiveness for both OS (p=0.043) and PFS (p=0.003).
[CONCLUSIONS] ICIs confer similar OS benefits in men and women with advanced NSCLC, but women show shorter PFS, particularly in PD-L1-positive and monotherapy settings. Further research should clarify the biological and clinical factors underlying these differences and ensure balanced representation and equitable evaluation in future trials.
[PROSPERO REGISTRATION NUMBER] CRD42024451670.