ADMET and DMPK, Vol. 13 No. 5, 2025.
Izvorni znanstveni članak
https://doi.org/10.5599/admet.2956
Pembrolizumab in PD-L1-positive advanced non-small cell lung carcinoma: A meta-analysis of survival benefits and immune-related toxicity events patterns
Alendra Chakramurty
; Department of Anatomical Pathology, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Indonesia
*
Adetya Rahma Dinni
; Department of Pulmonology, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Indonesia
Ihda Silvia
; Department of Internal Medicine, Gunung Jati General Hospital, Cirebon, Indonesia
Aprilyan Laras Cantika
; Department of Medical Education and Bioethics, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Indonesia
Citrawati Dyah Kencono Wungu
; Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
* Dopisni autor.
Sažetak
Background and objective: Pembrolizumab has shown significant therapeutic benefit in advanced non-small cell lung cancer (NSCLC), but it remains uncertain which patients will benefit the most, and recent data suggest that programmed death-ligand 1 (PD-L1) expression as a single predictive biomarker is insufficient. This systematic review and meta-analysis looked at the safety and efficacy of pembrolizumab in PD-L1-positive advanced NSCLC patients, with a particular focus on disparities in treatment response to PD-L1 level of expression and demographic characteristics. Method: According to the PRISMA 2020 guidelines, six large databases were searched up to March 2025 for randomized controlled trials comparing pembrolizumab with chemotherapy in patients with such conditions. Overall survival (OS) and progression-free survival (PFS) were chosen as primary outcomes, and overall response rate (ORR) and safety profiles as secondary endpoints. A meta-analysis was conducted using a random-effects model, and the Cochrane risk of bias (ROB2) tool was employed to evaluate study quality. Seven randomized controlled trials involving 4,900 patients were included in the analysis. Key results: Pembrolizumab had a substantially better performance compared to chemotherapy for all the measures of efficacy: OS (hazard ratio (HR) 0.65, 95 % confidence interval (CI): 0.57 to 0.73, P < 0.00001), PFS (HR 0.55, 95 % CI: 0.42 to 0.72, P < 0.0001) and ORR (relative risk 2.10, 95 % CI: 1.51 to 2.93, P < 0.0001). Subgroup analysis showed greater survival benefit in patients younger than 65 years (OS HR 0.55) compared to patients aged 65 and older (OS HR 0.72), and in females (OS HR 0.44) compared to males (OS HR 0.67). Of most significant importance, those with PD-L1 expression
Ključne riječi
pembrolizumab; meta-analysis; non-small cell lung cancer; PD-L1; immunotherapy; biomarker
Hrčak ID:
338685
URI
Datum izdavanja:
14.10.2025.
Posjeta: 476 *