1. Efficacy of Cancer Immunotherapy: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials.
- Author
-
Kim, Jong Yeob, Lee, Keum Hwa, Eisenhut, Michael, van der Vliet, Hans J., Kronbichler, Andreas, Jeong, Gwang Hun, Shin, Jae Il, and Gamerith, Gabriele
- Subjects
- *
THERAPEUTIC use of interferons , *THERAPEUTIC use of monoclonal antibodies , *RITUXIMAB , *ANTINEOPLASTIC agents , *CANCER chemotherapy , *CHRONIC lymphocytic leukemia , *CONFIDENCE intervals , *IMMUNOTHERAPY , *LUNG cancer , *LYMPHOMAS , *MEDLINE , *MELANOMA , *METASTASIS , *ONLINE information services , *SURVIVAL , *TUMORS , *SYSTEMATIC reviews , *TREATMENT effectiveness , *DESCRIPTIVE statistics - Abstract
We conducted a systematic review for evidence of the clinical efficacy of cancer immunotherapies. We searched PubMed from inception to 14 February 2018 for meta-analyses of randomized controlled trials (RCTs) of cancer immunotherapies. Re-analyses were performed to estimate the summary effect size under random-effects, the 95% confidence interval (CI), heterogeneity, and the 95% prediction interval, and we determined the strength of the evidence. We examined publication bias and excess significance bias. 63 articles corresponding to 247 meta-analyses were eligible. Nine meta-analyses were classified to have convincing evidence, and 75 were classified as suggestive evidence. The clinical benefit of immunotherapy was supported by convincing evidence in the following settings: anti-PD-1/PD-L1 monoclonal antibody (mAb) therapy for treating advanced melanoma and non-small cell lung cancer (NSCLC), the combination of rituximab and chemotherapy for treating chronic lymphocytic leukemia and B-cell non-Hodgkin's lymphoma, adoptive cell immunotherapy for NSCLC, and the combination of interferon α and chemotherapy for metastatic melanoma. A further meta-analysis of 16 RCTs showed that anti-PD-1/PD-L1 mAb therapy had a benefit in patients with solid tumors (overall survival; hazard ratio = 0.73, 95% CI: 0.68–0.79; p < 0.001), supported by convincing evidence. In the future, rigorous approaches are needed when interpreting meta-analyses to gain better insight into the true efficacy of cancer immunotherapy. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF