PD-(L)1 Inhibitor Monotherapy vs Chemoimmunotherapy for Advanced NSCLC With High PD-L1 Expression

Does chemoimmunotherapy improve outcomes compared with programmed cell death 1 protein or programmed cell death 1 ligand 1 (PD-[L]1) inhibitor monotherapy in patients with advanced NSCLC and PD-L1 expression of 50% or higher?In this meta-analysis of 24 randomized clinical trials including reconstructed individual patient data among a total of 5546 patients, chemoimmunotherapy was associated with significantly longer overall survival and progression-free survival compared with PD-(L)1 inhibitor monotherapy, with consistent findings across complementary analytic approaches and long-term sensitivity analyses.For treatment-naive patients with advanced NSCLC and high PD-L1 expression, combination chemoimmunotherapy may provide superior clinical benefit compared with PD-(L)1 monotherapy, supporting its consideration as a first-line treatment strategy pending results of prospective comparative trials.

Corresponding Author: Biagio Ricciuti, MD, PhD, Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215 (biagio_ricciuti@dfci.harvard.edu).

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