Image 2_PD-1/PD-L1 inhibitors plus bevacizumab plus chemotherapy versus PD-1/PD-L1 inhibitors plus chemotherapy for advanced non-small cell lung cancer: a phase 3 RCT based meta-analysis.tif

Background<p>Combining PD-1/PD-L1 inhibitors with chemotherapy (PIC) is a standard first-line treatment for advanced non-small cell lung cancer (NSCLC). The addition of bevacizumab to this regimen (PD-1/PD-L1 inhibitors+bevacizumab+chemotherapy [PIBC]) remains controversial regarding its poten...

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Main Author: Chao Song (379006) (author)
Other Authors: Yuan Qiu (405709) (author), Huan Fan (487588) (author), Yongqing Han (438395) (author)
Published: 2025
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author Chao Song (379006)
author2 Yuan Qiu (405709)
Huan Fan (487588)
Yongqing Han (438395)
author2_role author
author
author
author_facet Chao Song (379006)
Yuan Qiu (405709)
Huan Fan (487588)
Yongqing Han (438395)
author_role author
dc.creator.none.fl_str_mv Chao Song (379006)
Yuan Qiu (405709)
Huan Fan (487588)
Yongqing Han (438395)
dc.date.none.fl_str_mv 2025-05-21T05:23:47Z
dc.identifier.none.fl_str_mv 10.3389/fonc.2025.1496611.s010
dc.relation.none.fl_str_mv https://figshare.com/articles/figure/Image_2_PD-1_PD-L1_inhibitors_plus_bevacizumab_plus_chemotherapy_versus_PD-1_PD-L1_inhibitors_plus_chemotherapy_for_advanced_non-small_cell_lung_cancer_a_phase_3_RCT_based_meta-analysis_tif/29116811
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Oncology and Carcinogenesis not elsewhere classified
PD-1/PD-L1 inhibitors
bevacizumab
chemotherapy
non-small cell lung cancer
meta-analysis
dc.title.none.fl_str_mv Image 2_PD-1/PD-L1 inhibitors plus bevacizumab plus chemotherapy versus PD-1/PD-L1 inhibitors plus chemotherapy for advanced non-small cell lung cancer: a phase 3 RCT based meta-analysis.tif
dc.type.none.fl_str_mv Image
Figure
info:eu-repo/semantics/publishedVersion
image
description Background<p>Combining PD-1/PD-L1 inhibitors with chemotherapy (PIC) is a standard first-line treatment for advanced non-small cell lung cancer (NSCLC). The addition of bevacizumab to this regimen (PD-1/PD-L1 inhibitors+bevacizumab+chemotherapy [PIBC]) remains controversial regarding its potential to enhance antitumor efficacy in clinical practice. This meta-analysis aims to compare the antitumor effectiveness and safety profiles of PIBC with PIC.</p>Methods<p>We systematically searched six databases to identify eligible RCTs. The primary outcomes were overall survival (OS) and progression-free survival (PFS), while the secondary outcomes included treatment responses and adverse events (AEs).</p>Results<p>Three RCTs (IMpower150, jRCT2080224500, and ORIENT-31) comprising a total of 1529 patients were analyzed. The PIBC regimen significantly improved PFS (hazard ratio [HR]: 0.76 [0.66, 0.87], P < 0.0001), objective response rate (risk ratio [RR]: 1.36 [1.22, 1.51], P < 0.00001), and disease control rate (RR: 1.06 [1.00, 1.12], P = 0.04). The PFS rates were also higher in the PIBC group at 6 and 18 months. Both groups showed similar results in terms of OS, 3–36 month OS rates, and total AEs. However, the PIBC group exhibited a higher incidence of grade 3–5 AEs, serious AEs, grade 3–5 treatment-related AEs (TRAEs) and serious TRAEs. The most frequent grade 3–5 AEs in the PIBC group included anorexia (36.40%), decreased neutrophil count (16.25%), neutropenia (13.50%), reduced white blood cell count (12.12%), and febrile neutropenia (9.42%).</p>Conclusions<p>PIBC appears to be better than PIC for advanced NSCLC offering improved PFS and response rates (ORR and DCR). However, its higher incidence of AEs requires cautious attention.</p>Systematic review registration<p>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024559146, identifier CRD42024559146.</p>
eu_rights_str_mv openAccess
id Manara_3208b7cf225548a3c31f985c8a3ff3f7
identifier_str_mv 10.3389/fonc.2025.1496611.s010
network_acronym_str Manara
network_name_str ManaraRepo
oai_identifier_str oai:figshare.com:article/29116811
publishDate 2025
repository.mail.fl_str_mv
repository.name.fl_str_mv
repository_id_str
rights_invalid_str_mv CC BY 4.0
spelling Image 2_PD-1/PD-L1 inhibitors plus bevacizumab plus chemotherapy versus PD-1/PD-L1 inhibitors plus chemotherapy for advanced non-small cell lung cancer: a phase 3 RCT based meta-analysis.tifChao Song (379006)Yuan Qiu (405709)Huan Fan (487588)Yongqing Han (438395)Oncology and Carcinogenesis not elsewhere classifiedPD-1/PD-L1 inhibitorsbevacizumabchemotherapynon-small cell lung cancermeta-analysisBackground<p>Combining PD-1/PD-L1 inhibitors with chemotherapy (PIC) is a standard first-line treatment for advanced non-small cell lung cancer (NSCLC). The addition of bevacizumab to this regimen (PD-1/PD-L1 inhibitors+bevacizumab+chemotherapy [PIBC]) remains controversial regarding its potential to enhance antitumor efficacy in clinical practice. This meta-analysis aims to compare the antitumor effectiveness and safety profiles of PIBC with PIC.</p>Methods<p>We systematically searched six databases to identify eligible RCTs. The primary outcomes were overall survival (OS) and progression-free survival (PFS), while the secondary outcomes included treatment responses and adverse events (AEs).</p>Results<p>Three RCTs (IMpower150, jRCT2080224500, and ORIENT-31) comprising a total of 1529 patients were analyzed. The PIBC regimen significantly improved PFS (hazard ratio [HR]: 0.76 [0.66, 0.87], P < 0.0001), objective response rate (risk ratio [RR]: 1.36 [1.22, 1.51], P < 0.00001), and disease control rate (RR: 1.06 [1.00, 1.12], P = 0.04). The PFS rates were also higher in the PIBC group at 6 and 18 months. Both groups showed similar results in terms of OS, 3–36 month OS rates, and total AEs. However, the PIBC group exhibited a higher incidence of grade 3–5 AEs, serious AEs, grade 3–5 treatment-related AEs (TRAEs) and serious TRAEs. The most frequent grade 3–5 AEs in the PIBC group included anorexia (36.40%), decreased neutrophil count (16.25%), neutropenia (13.50%), reduced white blood cell count (12.12%), and febrile neutropenia (9.42%).</p>Conclusions<p>PIBC appears to be better than PIC for advanced NSCLC offering improved PFS and response rates (ORR and DCR). However, its higher incidence of AEs requires cautious attention.</p>Systematic review registration<p>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024559146, identifier CRD42024559146.</p>2025-05-21T05:23:47ZImageFigureinfo:eu-repo/semantics/publishedVersionimage10.3389/fonc.2025.1496611.s010https://figshare.com/articles/figure/Image_2_PD-1_PD-L1_inhibitors_plus_bevacizumab_plus_chemotherapy_versus_PD-1_PD-L1_inhibitors_plus_chemotherapy_for_advanced_non-small_cell_lung_cancer_a_phase_3_RCT_based_meta-analysis_tif/29116811CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/291168112025-05-21T05:23:47Z
spellingShingle Image 2_PD-1/PD-L1 inhibitors plus bevacizumab plus chemotherapy versus PD-1/PD-L1 inhibitors plus chemotherapy for advanced non-small cell lung cancer: a phase 3 RCT based meta-analysis.tif
Chao Song (379006)
Oncology and Carcinogenesis not elsewhere classified
PD-1/PD-L1 inhibitors
bevacizumab
chemotherapy
non-small cell lung cancer
meta-analysis
status_str publishedVersion
title Image 2_PD-1/PD-L1 inhibitors plus bevacizumab plus chemotherapy versus PD-1/PD-L1 inhibitors plus chemotherapy for advanced non-small cell lung cancer: a phase 3 RCT based meta-analysis.tif
title_full Image 2_PD-1/PD-L1 inhibitors plus bevacizumab plus chemotherapy versus PD-1/PD-L1 inhibitors plus chemotherapy for advanced non-small cell lung cancer: a phase 3 RCT based meta-analysis.tif
title_fullStr Image 2_PD-1/PD-L1 inhibitors plus bevacizumab plus chemotherapy versus PD-1/PD-L1 inhibitors plus chemotherapy for advanced non-small cell lung cancer: a phase 3 RCT based meta-analysis.tif
title_full_unstemmed Image 2_PD-1/PD-L1 inhibitors plus bevacizumab plus chemotherapy versus PD-1/PD-L1 inhibitors plus chemotherapy for advanced non-small cell lung cancer: a phase 3 RCT based meta-analysis.tif
title_short Image 2_PD-1/PD-L1 inhibitors plus bevacizumab plus chemotherapy versus PD-1/PD-L1 inhibitors plus chemotherapy for advanced non-small cell lung cancer: a phase 3 RCT based meta-analysis.tif
title_sort Image 2_PD-1/PD-L1 inhibitors plus bevacizumab plus chemotherapy versus PD-1/PD-L1 inhibitors plus chemotherapy for advanced non-small cell lung cancer: a phase 3 RCT based meta-analysis.tif
topic Oncology and Carcinogenesis not elsewhere classified
PD-1/PD-L1 inhibitors
bevacizumab
chemotherapy
non-small cell lung cancer
meta-analysis