{"_":"Efficacy and safety of Programmed Death Ligand 1 inhibitors Programmed Death 1 inhibitors in the first-line treatment of advanced non-small cell lung cancer: a meta-analysis of randomized controlled trials.","i":["versus"]}
随着免疫检查点抑制剂（ICI）在驱动基因突变阴性非小细胞肺癌（NSCLC）一线治疗中的应用日益增多，我们开展了一项系统评价和荟萃分析，旨在比较PD-L1抑制剂与PD-1抑制剂之间的疗效和不良反应（AE）。我们检索了PubMed、Web of Science、Embase和Cochrane Library，以识别与ICI单药或联合化疗一线治疗NSCLC相关的随机对照试验（RCT）。主要结局为总生存期（OS）、无进展生存期（PFS）和AE。共纳入28项RCT，涉及14,758例患者。与程序性死亡受体1（PD-1）抑制剂联合化疗相比，程序性死亡配体1（PD-L1）抑制剂联合化疗与更差的OS（风险比（HR）= 1.26；95%置信区间（CI）[1.13-1.41]；< 0.001）和PFS（HR = 1.21；95% CI [1.06-1.38]；= 0.005）相关。PD-1抑制剂联合化疗与PD-L1抑制剂联合化疗之间的客观缓解率（ORR）无差异（比值比（OR）= 0.91；95% CI [0.78-1.05]，= 0.205），且两组间AE发生率相似。关于单药治疗，PD-L1抑制剂与PD-1抑制剂之间未观察到OS、PFS或ORR的差异。PD-L1抑制剂导致终止治疗的不良反应及≥3级不良反应的发生率低于PD-1抑制剂（风险比（RR）= 0.55；95% CI [0.32-0.95]；= 0.03；RR = 0.76；95% CI [0.60-0.96]；= 0.021）。在NSCLC中，与PD-L1抑制剂联合化疗相比，PD-1抑制剂联合化疗可能提供显著的OS和PFS获益，且安全性特征相似。同时，PD-L1抑制剂单药治疗导致终止治疗或≥3级不良反应的可能性似乎低于PD-1抑制剂单药治疗。
With the increasing use of immune checkpoint inhibitors (ICIs) in the first-line treatment of driver mutation-negative non-small cell lung cancer (NSCLC), we conducted a systematic review and meta-analysis to compare efficacy and adverse effects (AEs) between PD-L1 inhibitors and PD-1 inhibitors. We searched PubMed, Web of Science, Embase, and the Cochrane Library to identify randomized controlled trials (RCTs) related to the first-line treatment of NSCLC with ICIs alone or in combination with chemotherapy. The primary outcomes were overall survival (OS), progression-free survival (PFS), and AEs. In total, 28 RCTs involving 14,758 patients were included. Compared with Programmed Death 1 (PD-1) inhibitors plus chemotherapy, Programmed Death Ligand 1 (PD-L1) inhibitors plus chemotherapy were associated with worse OS (hazard ratio (HR) = 1.26; 95% confidence interval (CI) [1.13-1.41]; < 0.001) and PFS (HR = 1.21; 95% CI [1.06-1.38]; = 0.005). The objective response rate (ORR) did not differ between PD-1 inhibitors plus chemotherapy and PD-L1 inhibitors plus chemotherapy (odds ratio (OR) = 0.91; 95% CI [0.78-1.05], = 0.205), and AE rates were similar between these groups. Regarding monotherapy, no difference in OS, PFS, or ORR was observed between PD-L1 and PD-1 inhibitors. The incidence of AEs leading to treatment termination and grade ≥3 AEs was lower for PD-L1 inhibitors than PD-1 inhibitors (risk ratio (RR) = 0.55; 95% CI [0.32-0.95]; = 0.03; RR = 0.76; 95% CI [0.60-0.96]; = 0.021). The combination of PD-1 inhibitors and chemotherapy may provide a significant OS and PFS benefit relative to PD-L1 inhibitors plus chemotherapy in NSCLC and a similar safety profile. Meanwhile, PD-L1 inhibitor monotherapy appears less likely to result in treatment termination or grade ≥3 AEs than PD-1 inhibitor monotherapy.
Cui Dang, Jingzhang Li, Hong Chen, Zoujie Luo. {"_":"Efficacy and safety of Programmed Death Ligand 1 inhibitors Programmed Death 1 inhibitors in the first-line treatment of advanced non-small cell lung cancer: a meta-analysis of randomized controlled trials.","i":["versus"]}. PeerJ. 2026; doi:10.7717/peerj.21402.
Cui Dang, Jingzhang Li, Hong Chen, Zoujie Luo (2026). {"_":"Efficacy and safety of Programmed Death Ligand 1 inhibitors Programmed Death 1 inhibitors in the first-line treatment of advanced non-small cell lung cancer: a meta-analysis of randomized controlled trials.","i":["versus"]}. PeerJ. https://doi.org/10.7717/peerj.21402
Cui Dang, Jingzhang Li, Hong Chen, Zoujie Luo. {"_":"Efficacy and safety of Programmed Death Ligand 1 inhibitors Programmed Death 1 inhibitors in the first-line treatment of advanced non-small cell lung cancer: a meta-analysis of randomized controlled trials.","i":["versus"]}[J]. PeerJ, 2026 doi:10.7717/peerj.21402.
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