Tislelizumab Plus Chemotherapy as First-Line Treatment for Locally Advanced or Metastatic Nonsquamous NSCLC (RATIONALE 304): A Randomized Phase 3 Trial.

Advanced-Stage Non–Small Cell Lung Cancer: Advances in Thoracic Oncology 2018

Immune checkpoint inhibitors (ICI) have become part of the standard of care of patients with locally advanced and advanced non-small cell lung cancer (NSCLC) (1). Corticosteroids are broadly used as premedication for most chemotherapy regimens and are frequently used to alleviate pain or dyspnea, to stimulate appetite, or to palliate symptoms associated with brain or epidural metastases. However, corticosteroids have anti-inflammatory and immunosuppressive effects that act over both innate and adaptive immunity. Based on this, patients treated with corticosteroids at doses equal to or higher than 10 mg/day of prednisone or equivalent have been systematically excluded from clinical trials of ICI.

/pdf/impact-of-baseline-steroids-on-efficacy-of-programmed-cell-4k2sujygzr.pdf

Impact of baseline steroids on efficacy of programmed cell death-1 (PD-1) and programmed death-ligand 1 (PD-L1) blockade in patients with advanced non-small cell lung cancer

Objective To explore the efficacy and safety of chemotherapy combined with immunotherapy as the first-line treatment of advanced or metastatic squamous NSCLC. Methods Two researchers independently searched PubMed, the Cochrane Library, EMBASE, CNKI, Wanfang Data, and other databases by using a computer, collected the clinical trials or randomized controlled trials published by April 2022 about immunotherapy combined with chemotherapy as the first-line treatment of advanced or metastatic squamous NSCLC, screened the literature, and extracted the data according to the nanodischarge criteria. We used Revman5.4 for statistical analysis of the included studies, and publication bias was analyzed with Egger’s test in Stata12. Results A total of seven clinical trials were included, including 1,510 cases in the chemotherapy combined with the immunotherapy group and 1,519 cases in the chemotherapy group. In terms of effectiveness, compared with the chemotherapy group, chemotherapy combined with immunotherapy for advanced or metastatic squamous NSCLC had longer overall survival (HR = 1.59, 95% CI: 1.46–1.72, p < 0.00001) and progression-free survival (HR = 1.84, 95% CI: 1.66–2.03, p < 0.00001). In terms of safety, the chemotherapy combined with immunotherapy group has a higher risk of adverse reactions at any level and above three levels of hematotoxicity, gastrointestinal abnormalities, and liver dysfunction than the chemotherapy group. Egger’s test has minor publication bias. Conclusion Chemotherapy combined with immunotherapy is effective as the first-line treatment for advanced or metastatic squamous NSCLC, but the risk of adverse reactions is relatively high. If there are adverse reactions in clinical application, it should be treated in time.

Chemotherapy Combined With Immunotherapy as a First-Line Treatment Brings Benefits to Patients With Lung Squamous Cell Carcinoma but Different Risks of Adverse Reactions: A Systematic Review and Meta-Analysis

In The New England Journal of Medicine , Paz-Ares and colleagues published the results of KEYNOTE-407, a randomized phase III placebo-controlled trial, investigating the addition of pembrolizumab or placebo to first-line carboplatin-taxane chemotherapy, in patients with advanced squamous non-small cell lung cancer (NSCLC) (1). The study met its co-primary end-points, since immune-chemotherapy combination led to a significant longer overall survival (OS) and progression-free survival (PFS) as compared to placebo combination.

/pdf/first-line-immune-chemotherapy-combination-the-right-5c4inxgzhj.pdf

First-line immune-chemotherapy combination: the right strategy to fight squamous non-small cell lung cancer?

MA10.08 Choice of Taxane and Outcomes in the KEYNOTE-407 Study of Pembrolizumab Plus Chemotherapy for Metastatic Squamous NSCLC

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MA10.08 Choice of Taxane and Outcomes in the KEYNOTE-407 Study of Pembrolizumab Plus Chemotherapy for Metastatic Squamous NSCLC