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Open AccessSystematic Review
Comparative Efficacy of Neoadjuvant Nivolumab Plus Chemotherapy versus Conventional Comparator Treatments in Resectable Non-Small-Cell Lung Cancer: A Systematic Literature Review and Network Meta-Analysis
by
Nicolas Girard
Nicolas Girard
Nicolas Girard is a pneumologist specializing in thoracic oncology,
for the treatment of patients [...]
Nicolas Girard is a pneumologist specializing in thoracic oncology,
for the treatment of patients with lung cancer or rare thoracic cancers.
His expertise ranges from the development of perioperative strategies
in resectable tumors, to the management of locally-advanced disease and
oncogene-addicted tumors, especially EGFR-mutant NSCLC. He is
experienced in the treatment of thymic tumors—thymomas and thymic
carcinomas—as part of his work in the RYTHMIC network. He is domain
leader for rare thoracic cancers for the European Reference Network
EURACAN. Nicolas Girard is involved in several clinical and
translational research projects aiming at improving the treatment of
these cancers. He is Professor of Respiratory Medicine
at Versailles Saint Quentin University, Paris Saclay Campus. He is the
Head of the Curie-Montsouris Thorax Institute, and Chair of the Medical
Oncology Departement at Institut Curie in Paris. Nicolas Girard has co-authored more than 300 articles in peer-reviewed journals.
1,2,†,
Mariam Besada
Mariam Besada
Mariam Besada is an Associate Director at Broadstreet. As a
public health professional, Mariam has [...]
Mariam Besada is an Associate Director at Broadstreet. As a
public health professional, Mariam has over seven years experience
contributing to published work on a range of topics including lung cancer,
melanoma, and anemia. At Broadstreet, Mariam has actively contributed to
evidence synthesis work in support of health technology assessment submissions.
Mariam has also been involved in developing and advocating for the use of novel
methods for evidence synthesis such as machine learning and expert elicitations.
Prior to her work at Broadstreet, Mariam worked as a research scientist at
PRECISIONheor and as an epidemiologist with the World Health Organization
(WHO). During her time at the WHO, she contributed to the development of a new
surveillance system for Zika and other vector-borne diseases. Mariam received
her BHSc and MPH from McMaster University and Columbia University,
respectively.
3,†,
Basia Rogula
Basia Rogula 3,
Stefano Lucherini
Stefano Lucherini 4,
Lien Vo
Lien Vo 5,
Mohammad A. Chaudhary
Mohammad A. Chaudhary 5,‡,
Sarah Goring
Sarah Goring 3
,
Greta Lozano-Ortega
Greta Lozano-Ortega 3
,
Mia Tran
Mia Tran 5,
Nebibe Varol
Nebibe Varol 4,
Nathalie Waser
Nathalie Waser 6
,
Jay M. Lee
Jay M. Lee 7 and
Jonathan Spicer
Jonathan Spicer 8,*
1
Department of Medical Oncology, Institut Curie, 75005 Paris, France
2
Paris Saclay University, University of Versailles Saint-Quentin-en-Yvelines (UVSQ), 78000 Versailles, France
3
BroadstreetHEOR, Vancouver, BC V6A 1A4, Canada
4
Bristol Myers Squibb, Uxbridge UB8 1DH, UK
5
Bristol Myers Squibb, Lawrenceville, NJ 08648, USA
6
ICON Plc, Burlington, ON L7N 3G2, Canada
7
UCLA Health, Los Angeles, CA 90095, USA
8
Department of Thoracic Surgery, McGill University Health Center, Montreal, QC H3G 1A4, Canada
*
Author to whom correspondence should be addressed.
‡
At the time research was conducted.
Submission received: 25 May 2024
/
Revised: 3 July 2024
/
Accepted: 5 July 2024
/
Published: 8 July 2024
Simple Summary
Lung cancer is the leading cause of cancer deaths worldwide. Surgery, with or without neoadjuvant or adjuvant chemotherapy has historically been the mainstay of treatment for resectable non-small-cell lung cancer (rNSCLC). However, as many as half of those treated still die of the disease. Immune checkpoint inhibitors are changing the landscape of treatment both in the neoadjuvant and adjuvant rNSCLC settings in many countries. In this review and analysis, outcomes among patients treated in the neoadjuvant setting (i.e., prior to surgery) with the immune checkpoint inhibitor nivolumab combined with chemotherapy were compared to those of patients treated with the historical standard of care treatments, using data from published studies. The results of this evidence synthesis show that neoadjuvant nivolumab when combined with chemotherapy improves the likelihood of event-free survival and a pathological complete response for patients relative to traditional treatments, specifically, surgery, alone or in combination with neoadjuvant or adjuvant (i.e., after surgery) chemotherapy, and neoadjuvant chemoradiotherapy.
Abstract
Background: This study aimed to estimate the relative efficacy of neoadjuvant nivolumab in combination with chemotherapy (neoNIVO + CT) compared to relevant treatments amongst resectable non-metastatic non-small-cell lung cancer (rNSCLC) patients. Methods: Treatment comparisons were based on a network meta-analysis (NMA) using randomized clinical trial data identified via systematic literature review (SLR). The outcomes of interest were event-free survival (EFS) and pathological complete response (pCR). NeoNIVO + CT was compared to neoadjuvant chemotherapy (neoCT), neoadjuvant chemoradiotherapy (neoCRT), adjuvant chemotherapy (adjCT), and surgery alone (S). Due to the potential for effect modification by stage, all-stage and stage-specific networks were considered. Fixed-effect (FE) and random-effects Bayesian NMA models were run (EFS = hazard ratios [HR]; pCR = odds ratios [OR]; 95% credible intervals [CrI]). Results: Sixty-one RCTs were identified (base case = 9 RCTs [n = 1978 patients]). In the all-stages FE model, neoNIVO + CT had statistically significant EFS improvements relative to neoCT (HR = 0.68 [95% CrI: 0.49, 0.94]), S (0.59 [0.42, 0.82]), adjCT (0.66 [0.45, 0.96]), but not relative to neoCRT (HR = 0.77 [0.52, 1.16]). NeoNIVO + CT (5 RCTs) had statistically significant higher odds of pCR relative to neoCT (OR = 12.53 [5.60, 33.82]) and neoCRT (7.15 [2.31, 24.34]). Stage-specific model findings were consistent. CONCLUSIONS: This NMA signals improved EFS and/or pCR of neoNIVO + CT relative to comparators among patients with rNSCLC.
Share and Cite
MDPI and ACS Style
Girard, N.; Besada, M.; Rogula, B.; Lucherini, S.; Vo, L.; Chaudhary, M.A.; Goring, S.; Lozano-Ortega, G.; Tran, M.; Varol, N.;
et al. Comparative Efficacy of Neoadjuvant Nivolumab Plus Chemotherapy versus Conventional Comparator Treatments in Resectable Non-Small-Cell Lung Cancer: A Systematic Literature Review and Network Meta-Analysis. Cancers 2024, 16, 2492.
https://doi.org/10.3390/cancers16132492
AMA Style
Girard N, Besada M, Rogula B, Lucherini S, Vo L, Chaudhary MA, Goring S, Lozano-Ortega G, Tran M, Varol N,
et al. Comparative Efficacy of Neoadjuvant Nivolumab Plus Chemotherapy versus Conventional Comparator Treatments in Resectable Non-Small-Cell Lung Cancer: A Systematic Literature Review and Network Meta-Analysis. Cancers. 2024; 16(13):2492.
https://doi.org/10.3390/cancers16132492
Chicago/Turabian Style
Girard, Nicolas, Mariam Besada, Basia Rogula, Stefano Lucherini, Lien Vo, Mohammad A. Chaudhary, Sarah Goring, Greta Lozano-Ortega, Mia Tran, Nebibe Varol,
and et al. 2024. "Comparative Efficacy of Neoadjuvant Nivolumab Plus Chemotherapy versus Conventional Comparator Treatments in Resectable Non-Small-Cell Lung Cancer: A Systematic Literature Review and Network Meta-Analysis" Cancers 16, no. 13: 2492.
https://doi.org/10.3390/cancers16132492
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