Abstract:

Objective To perfrom a meta-analyze of the efficacy of PD-1/PD-L1 inhibitors versus chemotherapy in the treatment of patients with NSCLC brain metastases. Methods Search of the literature included in Pubmed, Embase, Sciencedirect, Cochrane, X-mol, CNKI, Wanfang and other databases on the Internet. Two researchers screened the literature, extracted data and evaluated the risk of bias and adopted RevMan 5.3 performs meta-analysis on the overall survival (OS) and progress free survival (PFS) of NSCLC brain metastasis.Results A total of 7 RCTs were included, including 440 patients with NSCLC brain metastases. Compared with simple chemotherapy group, PD-1/PD-L1 inhibitors could markedly increase the patient's OS [HR=0.71, 95%CI(0.56, 0.92), P=0.008] and PFS[HR=0.53, 95%CI(0.41, 0.69), P<0.01]; OS [HR=0.41, 95%CI(0.24, 0.70), P=0.001] and PFS [HR=0.44, 95%CI(0.30, 0.63), P<0.01] in PD-1/PD-L1 inhibitors combined with chemotherapy group compared with OS [HR=0.83, 95%CI (0.63, 1.11), P=0.21] and PFS[HR=0.64, 95%CI(0.45, 0.91),P=0.01] in the monotherapy group could more significantly reduce the patient's risk of death and disease progression.Conclusion PD-1/PD-L1 inhibitors alone or in combination with chemotherapy for patients with NSCLC brain metastases have better effect than chemotherapy, and the combined chemotherapy group is better than monotherapy, which is a preferred treatment for patients with NSCLC brain metastases.

Key words: carcinoma,non-small-cell lung, brain metastases, PD-1/PD-L1 inhibitors, immunotherapy