Efficacy of Adding Immune Checkpoint Inhibition to Chemotherapy, With or Without VEGF Inhibition, in Patients With Advanced -Mutated NSCLC: A Systematic Review and Meta-Analysis With Reconstructed Individual Patient Data.
[INTRODUCTION] Whether adding immunotherapy to chemotherapy is beneficial for some patients with -mutated NSCLC and whether concomitant vascular endothelial growth factor inhibition (VEGFi) further en
- 표본수 (n) 2196
- 95% CI 0.74-0.93
- HR 0.83
- 연구 설계 systematic review
APA
Di Federico A, Stumpo S, et al. (2026). Efficacy of Adding Immune Checkpoint Inhibition to Chemotherapy, With or Without VEGF Inhibition, in Patients With Advanced -Mutated NSCLC: A Systematic Review and Meta-Analysis With Reconstructed Individual Patient Data.. JTO clinical and research reports, 7(4), 100961. https://doi.org/10.1016/j.jtocrr.2026.100961
MLA
Di Federico A, et al.. "Efficacy of Adding Immune Checkpoint Inhibition to Chemotherapy, With or Without VEGF Inhibition, in Patients With Advanced -Mutated NSCLC: A Systematic Review and Meta-Analysis With Reconstructed Individual Patient Data.." JTO clinical and research reports, vol. 7, no. 4, 2026, pp. 100961.
PMID
42005789
Abstract
[INTRODUCTION] Whether adding immunotherapy to chemotherapy is beneficial for some patients with -mutated NSCLC and whether concomitant vascular endothelial growth factor inhibition (VEGFi) further enhances this strategy are still subjects of debate.
[METHODS] We performed a systematic review and meta-analysis with reconstructed individual patient data to assess outcomes to chemo-immunotherapy with or without VEGFi in patients with advanced -mutated NSCLC after failure of EGFR tyrosine kinase inhibitors.
[RESULTS] Among seven randomized clinical trials (n = 2196 patients), compared with chemotherapy with or without VEGFi, chemo-immunotherapy extended the median progression-free survival whether combined with VEGFi (8.1 versus 5.5 mo; hazard ratio [HR]: 0.59; 95% confidence interval [CI]: 0.53-0.67; < 0.0001) or not (5.6 versus 5.5 mo; HR: 0.83; 95% CI: 0.74-0.93; = 0.0017). Adding VEGFi to chemo-immunotherapy prolonged the progression-free survival even compared with chemo-immunotherapy alone (HR: 0.72; 95% CI: 0.63-0.82; < 0.0001). Similarly, median overall survival was extended by chemo-immunotherapy with VEGFi (19.0 versus 15.7 mo; HR: 0.77; 95% CI: 0.67-0.89; = 0.00046) and without VEGFi (18.1 versus 15.7 mo; HR: 0.86; 95% CI: 0.76-0.97; = 0.018) compared with chemotherapy with or without VEGFi. However, adding VEGFi to chemo-immunotherapy did not extend the median overall survival compared with chemo-immunotherapy alone (HR: 0.90; 95% CI: 0.77-1.05; = 0.18). These results were consistent in trial-level HR meta-analyses, where chemo-immunotherapy, only when combined with VEGFi, also improved the objective response rate versus chemotherapy with or without VEGFi. Patients with PD-L1 more than or equal to 1% or L858R mutations achieved greater PFS benefit with chemo-immunotherapy with or without VEGFi.
[CONCLUSION] Chemo-immunotherapy with or without VEGFi may produce a modest survival improvement in select patients with -mutated NSCLC compared with chemotherapy. Identifying biomarkers able to predict a clinically meaningful benefit is warranted.
[METHODS] We performed a systematic review and meta-analysis with reconstructed individual patient data to assess outcomes to chemo-immunotherapy with or without VEGFi in patients with advanced -mutated NSCLC after failure of EGFR tyrosine kinase inhibitors.
[RESULTS] Among seven randomized clinical trials (n = 2196 patients), compared with chemotherapy with or without VEGFi, chemo-immunotherapy extended the median progression-free survival whether combined with VEGFi (8.1 versus 5.5 mo; hazard ratio [HR]: 0.59; 95% confidence interval [CI]: 0.53-0.67; < 0.0001) or not (5.6 versus 5.5 mo; HR: 0.83; 95% CI: 0.74-0.93; = 0.0017). Adding VEGFi to chemo-immunotherapy prolonged the progression-free survival even compared with chemo-immunotherapy alone (HR: 0.72; 95% CI: 0.63-0.82; < 0.0001). Similarly, median overall survival was extended by chemo-immunotherapy with VEGFi (19.0 versus 15.7 mo; HR: 0.77; 95% CI: 0.67-0.89; = 0.00046) and without VEGFi (18.1 versus 15.7 mo; HR: 0.86; 95% CI: 0.76-0.97; = 0.018) compared with chemotherapy with or without VEGFi. However, adding VEGFi to chemo-immunotherapy did not extend the median overall survival compared with chemo-immunotherapy alone (HR: 0.90; 95% CI: 0.77-1.05; = 0.18). These results were consistent in trial-level HR meta-analyses, where chemo-immunotherapy, only when combined with VEGFi, also improved the objective response rate versus chemotherapy with or without VEGFi. Patients with PD-L1 more than or equal to 1% or L858R mutations achieved greater PFS benefit with chemo-immunotherapy with or without VEGFi.
[CONCLUSION] Chemo-immunotherapy with or without VEGFi may produce a modest survival improvement in select patients with -mutated NSCLC compared with chemotherapy. Identifying biomarkers able to predict a clinically meaningful benefit is warranted.
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