mechanism | treatment | Demonstrated benefit and harm | k | | | |
---|
angiogenesis inhibitors | aflibercept | versus No demonstrated result for efficacy | 1 trial | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
| T1 vs T0 | | | |
Trial | Treatments | Patients | Method |
---|
Ramlau, 2012 | (n=456) vs. (n=457) | platinum-pretreated patients with advanced or metastatic nonsquamous non-small-cell lung cancer | double-blind Sample size: 456/457 Primary endpoint: overall survival (OS). FU duration: phase III |
|
angiogenesis inhibitors | bevacizumab | versus No demonstrated result for efficacy | 6 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
| T1 vs T0 | | | | | T1 vs T0 | | | | | T1 vs T0 | | | | | T1 vs T0 | | | | | T1 vs T0 | | | | | T1 vs T0 | | | |
Trial | Treatments | Patients | Method |
---|
Reck, 2010 | GP+bev (n=-9) vs. GP (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: | Sandler, 2006 | PCp +bev (n=-9) vs. PCp (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: | Johnson, 2004 | PCp +bev (n=-9) vs. PCp (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: | Nishio, 2009 | PCp +bev (n=-9) vs. PCp (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: | Herbst, 2007 | D/M +bev (n=-9) vs. D/M (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: | Herbst, 2011 | erl+bev (n=-9) vs. erl (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: |
|
angiogenesis inhibitors | ceritinib | versus No demonstrated result for efficacy | 3 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
| T1 vs T0 | | | | | T1 vs T0 | | | | | T1 vs T0 | | | |
Trial | Treatments | Patients | Method |
---|
Laurie, 2014 | cediranib 20mg daily to carboplatin/paclitaxel (n=-9) vs. (n=-9) | patients with advanced non-small cell lung cancer | double-blind Sample size: -9/-9 Primary endpoint: FU duration: | Dy, 2013 | (n=-9) vs. (n=-9) | first-line therapy in advanced non-small-cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: phase II | Goss, 2010 | (n=-9) vs. (n=-9) | initial therapy for advanced non-small-cell lung cancer | double-blind Sample size: -9/-9 Primary endpoint: FU duration: phase II/III |
|
angiogenesis inhibitors | motesanib | versus No demonstrated result for efficacy | 1 trial | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
| T1 vs T0 | | | |
Trial | Treatments | Patients | Method |
---|
Scagliottib MONET1, 2012 | carboplatin (area under the curve, 6 mg/ml · min) and paclitaxel (200 mg/m(2)) intravenously for up to six 3-week cycles plus either motesanib 125 mg (n=-9) vs. (n=-9) | patients with advanced nonsquamous non-small-cell lung cancer | double-blind Sample size: -9/-9 Primary endpoint: OS FU duration: phase III |
|
angiogenesis inhibitors | pazopanib | versus No demonstrated result for efficacy | 1 trial | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
| T1 vs T0 | | | |
Trial | Treatments | Patients | Method |
---|
Scagliotti, 2013 | pazopanib in combination with pemetrexed (n=-9) vs. (n=-9) | first-line treatment of patients with advanced-stage non-small-cell lung cancer | open-label Sample size: -9/-9 Primary endpoint: progression-free survival (PFS). FU duration: phase II |
|
angiogenesis inhibitors | sorafenib | versus No demonstrated result for efficacy | 4 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
| T1 vs T0 | | | | | T1 vs T0 | | | | | T1 vs T0 | | | | | T1 vs T0 | | | |
Trial | Treatments | Patients | Method |
---|
Wakelee, 2012 | (n=-9) vs. (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: phase-II | Paz-Ares, 2012 | daily sorafenib (400 mg twice a day) or matching placebo plus gemcitabine (1,250 mg/m(2) per day on days 1 and 8) and cisplatin (75 mg/m(2) on day 1) for up to six 21-day cycles (n=385) vs. gemcitabine/cisplatin alone (n=-9387) | chemotherapy-naive patients with unresectable stage IIIB to IV nonsquamous non-small-cell lung cancer | Sample size: 385/-9387 Primary endpoint: FU duration: | Spigel, 2011 | (n=-9) vs. (n=-9) | previously treated advanced non-small-cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: phase II | Scagliotti, 2010 | up to six 21-day cycles of carboplatin area under the curve 6 and paclitaxel 200 mg/m(2) (CP) on day 1, followed by sorafenib 400 mg twice a day on days 2 to 19 (n=464) vs. (n=462) | chemotherapy-naïve patients with unresectable stage IIIB or IV non-small-cell lung cancer | Sample size: 464/462 Primary endpoint: FU duration: phase III |
|
angiogenesis inhibitors | sunitinib | versus No demonstrated result for efficacy | 3 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
| T1 vs T0 | | | | | T1 vs T0 | | | | | T1 vs T0 | | | |
Trial | Treatments | Patients | Method |
---|
Heist CALGB 30704 (Alliance): , 2014 | (n=-9) vs. (n=-9) | second-line treatment of advanced non-small-cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: | Groen, 2013 | sunitinib 37.5 mg/day plus erlotinib 150 mg/day continuously in 4-week cycles (n=-9) vs. placebo plus erlotinib (n=-9) | second-line treatment of metastatic non-small-cell lung cancer | double-blind Sample size: -9/-9 Primary endpoint: FU duration: phase II phase II | Scagliottia, 2012 | (n=-9) vs. (n=-9) | patients with previously treated advanced non-small-cell lung cancer | Sample size: -9/-9 Primary endpoint: OS FU duration: phase III |
|
angiogenesis inhibitors | vandetanib | versus No demonstrated result for efficacy | 7 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
| T1 vs T0 | | | | | T1 vs T0 | | | | | T1 vs T0 | | | | | T1 vs T0 | | | | | T1 vs T0 | | | | | T1 vs T0 | | | | | T1 vs T0 | | | |
Trial | Treatments | Patients | Method |
---|
Aisner, 2013 | vandetanib or placebo as maintenance (n=-9) vs. (n=-9) | patients with advanced non-small-cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: phase 2 | Ahn, 2013 | (n=-9) vs. (n=-9) | advanced or metastatic non-small-cell lung cancer following first-line platinum-doublet chemotherapy | Sample size: -9/-9 Primary endpoint: progression-free survival (PFS) rate at 3 months FU duration: phase II | Lee ZEPHYR, 2012 | vandetanib 300 mg/d (n=617) vs. placebo (n=307) | patients with advanced non-small-cell lung cancer after prior therapy with an epidermal growth factor receptor tyrosine kinase inhibitor | Sample size: 617/307 Primary endpoint: overall survival FU duration: | Natale, 2011 | once-daily vandetanib 300 mg (n=83) vs. gefitinib 250 mg (n=85) | patients with advanced non-small-cell lung cancer | double-blind Sample size: 83/85 Primary endpoint: FU duration: phase ii | de Boer, 2011 | vandetanib 100 mg/d plus pemetrexed 500 mg/m(2) every 21 days (n=256) vs. placebo plus pemetrexed (n=278) | second-line treatment of advanced non-small-cell lung cancer | double-blind Sample size: 256/278 Primary endpoint: Progression-free survival (PFS) FU duration: | Natale, 2009 | (n=-9) vs. (n=-9) | | double-blind Sample size: -9/-9 Primary endpoint: FU duration: phase ii | Heymach, 2007 | vandetanib (100 or 300 mg/d) plus docetaxel (75 mg/m2 intravenous infusion every 21 days) (n=-9) vs. placebo plus docetaxel (n=-9) | previously treated non small-cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: phase II |
|
antifolates | pemetrexed | versus No demonstrated result for efficacy pemetrexed plus carboplatin inferior to pemetrexed in terms of ORR in Smit, 2009 | 7 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
Smit, 2009 | pemetrexed plus carboplatin vs pemetrexed | PFS 0.67 [0.51; 0.89] | ORR 2.91 [1.18; 7.15] | OS 0.85 [0.62; 1.17] | Chen, 2008 | pemetrexed vs docetaxel | | | | Hanna, 2004 | pemetrexed vs docetaxel | | | | Jose, 2011 | pemetrexed plus carboplatin vs docetaxel plus carboplatin | | | | Li, 2012 | pemetrexed vs docetaxel | | | | Socinski, 2010 | pemetrexed plus carboplatin vs docetaxel plus carboplatin | | | | Sun, 2013 | pemetrexed vs docetaxel | | | |
Trial | Treatments | Patients | Method |
---|
Smit, 2009 | Pemetrexed plus carboplatin (n=-9) vs. pemetrexed (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: phase 2 | Chen, 2008 | (n=34) vs. (n=33) | | Sample size: 34/33 Primary endpoint: FU duration: | Hanna, 2004 | pemetrexed 500 mg/m(2) intravenously (i.v.) day 1 with vitamin B(12), folic acid, and dexamethasone (n=283) vs. docetaxel 75 mg/m(2) i.v. day 1 with dexamethasone every 21 days (n=288) | patients with advanced non-small-cell lung cancer (NSCLC) previously treated with chemotherapy | Sample size: 283/288 Primary endpoint: overall survival FU duration: | Jose, 2011 | carboplatin (area under the curve = 5 mg/ml × min) and pemetrexed (500 mg/m(2)) 21-day cycle (maximum of six cycles). (n=106) vs. docetaxel (75 mg/m(2)). (n=105) | first-line treatment for advanced, nonsquamous non-small cell lung cancer | Sample size: 106/105 Primary endpoint: survival without treatment-emergent grade 3/4 toxicity FU duration: | Li, 2012 | pemetrexed 500 mg/m(2) intravenously day 1 with vitamin B12, folic acid, and dexamethasone (n=132) vs. docetaxel 75 mg/m(2) intravenously day 1 with dexamethasone (n=128) | patients with histological or cytological diagnosis of stage IIIB or IV NSCLC, who were not suitable for curative therapy and had failed from prior first line chemotherapy regimen for at least 4 weeks | Sample size: 132/128 Primary endpoint: overall response rate (ORR) FU duration: | Socinski, 2010 | pemetrexed 500 mg/m and carboplatin area under the curve 6 once every 3 weeks for up to 6 cycles (n=74) vs. docetaxel 75 mg/m and carboplatin area under the curve 6 once every 3 weeks for up to six cycles (n=72) | Patients with stage IIIB (with pleural effusion) or IV non-small cell lung cancer and performance status 0 or 1 | Sample size: 74/72 Primary endpoint: time to disease progression (TTP). FU duration: | Sun, 2013 | pemetrexed (500 mg/m(2); on Day 1 of each 21-day cycle (n=107) vs. docetaxel (75 mg/m(2) on Day 1 of each 21-day cycle (n=104) | second-line therapy for Chinese patients with locally advanced or metastatic non-small cell lung cancer | open-label Sample size: 107/104 Primary endpoint: FU duration: |
|
antifolates | vandetanib | versus No demonstrated result for efficacy vandetanib plus pemetrexed inferior to pemetrexed in terms of ORR in De Boer, 2011 | 1 trial | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
De Boer, 2011 | vandetanib plus pemetrexed vs pemetrexed | | ORR 2.42 [1.42; 4.12] | OS 0.89 [0.73; 1.09] PFS 0.83 [0.68; 1.01] |
Trial | Treatments | Patients | Method |
---|
De Boer, 2011 | Vandetanib plus pemetrexed (n=-9) vs. pemetrexed (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: phase 3 |
|
CDK (cyclin-dependent kinase) inhibitor | abemaciclib | versus No demonstrated result for efficacy | 1 trial | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
| T1 vs T0 | | | |
Trial | Treatments | Patients | Method |
---|
JUNIPER, 2018 | 200 mg of abemaciclib orally twice daily (n=453) vs. 150 mg of erlotinib (n=0) | patients with stage IV NSCLC with a detectable KRAS mutation who progressed after platinum-based chemotherapy and who may have received 1 additional systemic therapy | open-label Parallel groups Sample size: 453/0 Primary endpoint: OS FU duration: phase 3 |
|
EGFR inhibitors | afatinib | versus No demonstrated result for efficacy | 2 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
LUX-LUNG 3, 2015 | afatinib vs cisplatin-based chemotherapy | | | | LUX-LUNG 6, 2015 | afatinib vs cisplatin-based chemotherapy | | | |
Trial | Treatments | Patients | Method |
---|
LUX-LUNG 3, 2015 | (n=-9) vs. (n=-9) | EGFR mutation-positive lung adenocarcinoma | Sample size: -9/-9 Primary endpoint: FU duration: | LUX-LUNG 6, 2015 | (n=-9) vs. (n=-9) | EGFR mutation-positive lung adenocarcinoma | Sample size: -9/-9 Primary endpoint: FU duration: |
|
EGFR inhibitors | alectinib | versus crizotinib alectinib superior to crizotinib in terms of PFS in ALEX, 2017 (1L patients) | 1 trial | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
ALEX, 2017 | alectinib vs crizotinib | PFS 0.47 [0.34; 0.65] median NR vs. 11.1 mo Demonstrated | | OS 0.76 [0.48; 1.20] median NR vs. NR |
Trial | Treatments | Patients | Method |
---|
ALEX, 2017 | alectinib 600 mg orally (four 150 mg capsules) BID (n=152) vs. Crizotinib (n=151) | patients with stage IIIB or IV, ALK-positive NSCLC who had not received prior systemic therapy | open label Parallel groups Sample size: 152/151 Primary endpoint: Investigator assessed PFS FU duration: |
|
EGFR inhibitors | ceritinib | versus chemotherapy No demonstrated result for efficacy | 2 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
ASCEND-4, 2017 | ceritinib vs chemotherapy | PFS 0.55 [0.42; 0.73] median 16.6 vs. 8.1 | | OS 0.73 [0.50; 1.07] median NR vs. 26.2 | ASCEND 5, 2017 | ceritinib vs pemetrexed or docetaxel | | | |
Trial | Treatments | Patients | Method |
---|
ASCEND-4, 2017 | oral ceritinib 750 mg/day (n=189) vs. platinum-based chemotherapy ([cisplatin 75 mg/m2 or carboplatin AUC 5-6 plus pemetrexed 500 mg/m2] every 3 weeks for four cycles followed by maintenance pemetrexed (n=187) | untreated patients with stage IIIB/IV ALK-rearranged non-squamous NSCLC | open-label Sample size: 189/187 Primary endpoint: pfs FU duration: | ASCEND 5, 2017 | Oral LDK378 750 mg once daily (n=-9) vs. pemetrexed or docetaxel (n=-9) | patients previously treated with chemotherapy (platinum doublet) and crizotinib | Sample size: -9/-9 Primary endpoint: PFS FU duration: |
|
EGFR inhibitors | cetuximab | versus No demonstrated result for efficacy | 4 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
Lynch, 2010 | cetuximab vs CT | | | OS 0.89 [0.75; 1.05] median 9.69 mo vs. 8.38 mo PFS 0.90 [0.76; 1.07] median 4.40 mo vs. 4.24 mo | FLEX (Pirker), 2009 | cetuximab + CT vs CT alone | OS 0.87 [0.76; 1.00] median 11.3 mo vs. 10.1 mo | | | Rosell, 2008 | cetuximab + CT vs CT alone | | | | Butts, 2007 | cetuximab vs CT alone | | | |
Trial | Treatments | Patients | Method |
---|
Lynch, 2010 | cetuximab (400 mg/m(2) on day 1, 250 mg/m(2) weekly) was administered until progression or unacceptable toxicity plus taxane/carboplatin (n=-9) vs. paclitaxel (225 mg/m(2)) or docetaxel (75 mg/m(2)), at the investigator's discretion, and carboplatin (area under the curve = 6) on day 1 every 3 weeks for < or = six cycles (n=-9) | chemotherapy-naïve patients with stage IIIB (pleural effusion) or IV NSCLC, without restrictions by histology or epidermal growth factor receptor expression | open-label Sample size: -9/-9 Primary endpoint: progression-free survival FU duration: phase III | FLEX (Pirker), 2009 | Cetuximab-at a starting dose of 400 mg/m(2) intravenous infusion over 2 h on day 1, and from day 8 onwards at 250 mg/m(2) over 1 h per week-was continued after the end of chemotherapy until disease progression or unacceptable toxicity + CT (n=557) vs. cisplatin 80 mg/m(2) intravenous infusion on day 1, and vinorelbine 25 mg/m(2) intravenous infusion on days 1 and 8 of every 3-week cycle) for up to six cycles (n=568) | chemotherapy-naive patients with advanced EGFR-expressing histologically or cytologically proven stage wet IIIB or stage IV non-small-cell lung cancer | open-label Sample size: 557/568 Primary endpoint: overall survival FU duration: | Rosell, 2008 | cetuximab treatment (initial dose 400 mg/m(2), followed by 250 mg/m(2) weekly thereafter) + same CT (n=43) vs. for a maximum of eight cycles, patients received three-weekly cycles of cisplatin (80 mg/m(2), day 1) and vinorelbine (25 mg/m(2) on days 1 and 8) alone (n=43) | first-line therapy in EGFR-expressing advanced non-small-cell lung cancer | Sample size: 43/43 Primary endpoint: FU duration: | Butts, 2007 | cetuximab (400 mg/m2 i.v (n=65) vs. cisplatin (75 mg/m2 i.v., every 3 weeks) or carboplatin (area under the concentration-versus-time curve of 5 intravenously [i.v.], every 3 weeks), and gemcitabine (1,250 or 1,000 mg/m2 i.v., days 1 and 8) (n=66) | chemotherapy-naïve patients with recurrent/metastatic NSCLC (stage IV or stage IIIB with malignant pleural effusion) | Sample size: 65/66 Primary endpoint: Response rate FU duration: phase II |
|
EGFR inhibitors | crizotinib | versus chemotherapy No demonstrated result for efficacy | 2 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
Shaw, 2013 | crizotinib vs chemotherapy | PFS 0.49 [0.37; 0.64] | | OS 1.02 [0.68; 1.53] | PROFILE 1014, 2014 | crizotinib vs chemotherapy | PFS 0.45 [0.34; 0.59] median 10.9 vs. 7.0 mo | | OS 0.82 [0.54; 1.25] median NR vs. NR |
Trial | Treatments | Patients | Method |
---|
Shaw, 2013 | crizotinib (250 mg) twice daily (n=-9) vs. intravenous chemotherapy with either pemetrexed (500 mg per square meter of body-surface area) or docetaxel (75 mg per square meter) every 3 weeks (n=-9) | patients with locally advanced or metastatic ALK-positive lung cancer who had received one prior platinum-based regimen | open-label Parallel groups Sample size: -9/-9 Primary endpoint: PFS FU duration: | PROFILE 1014, 2014 | oral crizotinib, at a dose of 250 mg twice daily (n=172) vs. Standard Chemotherapy Pemetrexed Plus Cisplatin Or Carboplatin (n=171) | patients with advanced ALK-positive nonsquamous NSCLC who had
received no previous systemic treatment for advanced disease | open-label Sample size: 172/171 Primary endpoint: progression-free survival FU duration: 16.7 months |
|
EGFR inhibitors | dacomitinib | versus No demonstrated result for efficacy | 1 trial | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
| T1 vs T0 | | | |
Trial | Treatments | Patients | Method |
---|
ARCHER 1050 | dacomitinib (n=-9) vs. gefitinib (n=-9) | Patients (pts) with newly diagnosed stage IIIB/IV/ recurrent NSCLC harboring an EGFR- activating mutation (exon 19 del or exon 21 L858R mu +/- exon 20 T790M mu) | Sample size: -9/-9 Primary endpoint: IRC PFS FU duration: |
|
EGFR inhibitors | erlotinib | versus No demonstrated result for efficacy | 11 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
OPTIMAL | erlotinib vs Platinum-based CT | PFS 0.16 [0.10; 0.26] median 13.1 mo vs. 4.6 mo | | | EUTRAC | erlotinib vs Platinum-based CT | PFS 0.37 [0.25; 0.54] | | | TITAN | erlotinib vs Platinum-based CT | | | OS 0.96 [0.78; 1.19] | TRIBUTE (Herbst) | erlotinib + Platinum-based CT vs Platinum-based CT | | | OS 1.00 [0.86; 1.16] ORR 1.11 [0.73; 1.68] | Gatzemeier | erlotinib + Platinum-based CT vs Platinum-based CT | | | PFS 0.98 [0.86; 1.11] ORR 1.05 [0.89; 1.24] | Mok | erlotinib + Platinum-based CT vs Platinum-based CT | PFS 0.71 [0.62; 0.82] | | OS 1.09 [0.70; 1.69] ORR 1.46 [0.89; 2.39] | SATURN (Cappuzzo) | erlotinib + Platinum-based CT vs Platinum-based CT | OS 0.81 [0.70; 0.94] | | | Boutsikou | erlotinib + Platinum-based CT vs Platinum-based CT | | | OS 0.81 [0.39; 1.69] | Lee | erlotinib + Platinum-based CT vs Platinum-based CT | PFS 0.58 [0.39; 0.86] ORR 1.56 [1.02; 2.38] | | OS 0.75 [0.49; 1.14] | Stinchcombe | erlotinib + Platinum-based CT vs Platinum-based CT | | | OS 1.20 [0.76; 1.90] PFS 0.87 [0.60; 1.27] ORR 3.16 [0.94; 10.62] | FASTACT-2 (Wu) | erlotinib + Platinum-based CT vs Platinum-based CT | OS 0.79 [0.64; 0.98] PFS 0.57 [0.47; 0.69] ORR 2.36 [1.72; 3.23] | | |
Trial | Treatments | Patients | Method |
---|
OPTIMAL | oral erlotinib (150 mg/day) until disease progression or unacceptable toxic effects (n=83) vs. up to four cycles of gemcitabine plus carboplatin (n=82) | Patients older than 18 years with histologically confirmed stage IIIB or IV NSCLC and a confirmed activating mutation of EGFR (exon 19 deletion or exon 21 L858R point mutation) | open-label Sample size: 83/82 Primary endpoint: progression-free survival FU duration: | EUTRAC | oral erlotinib 150 mg per day (n=-9) vs. 3 week cycles of standard intravenous chemotherapy of cisplatin 75 mg/m(2) on day 1 plus docetaxel (75 mg/m(2) on day 1) or gemcitabine (1250 mg/m(2) on days 1 and 8). (n=-9) | adults (> 18 years) with NSCLC and EGFR mutations (exon 19 deletion or L858R mutation in exon 21) with no history of chemotherapy for metastatic disease (neoadjuvant or adjuvant chemotherapy ending ¡Ý 6 months before study entry was allowed) | open-label Sample size: -9/-9 Primary endpoint: FU duration: | TITAN | erlotinib 150 mg/day (n=-9) vs. chemotherapy (standard docetaxel or pemetrexed regimens, at the treating investigators' discretion) until unacceptable toxicity, disease progression, or death (n=-9) | second-line treatment of patients with advanced, non-small-cell lung cancer with poor prognosis | open-label Sample size: -9/-9 Primary endpoint: FU duration: | TRIBUTE (Herbst) | erlotinib 150 mg/d combined with up to six cycles of carboplatin and paclitaxel, followed by maintenance monotherapy with erlotinib (n=526) vs. placebo combined with up to six cycles of carboplatin and paclitaxel, followed by maintenance monotherapy with erlotinib (n=533) | patients with good performance status and previously untreated advanced (stage IIIB/IV) NSCLC | Sample size: 526/533 Primary endpoint: overall survival FU duration: | Gatzemeier | Erl 150 mg/day plus (Gem 1,250 mg/m2 D1,8 and Cis 80 mg/m2 D1)*6 cycles (n=579) vs. Gem 1,250 mg/m2 D1,8 and Cis 80 mg/m2 D1)*6 cycles (n=580) | first-line treatment for advanced non-small-cell lung cancer | Sample size: 579/580 Primary endpoint: FU duration: | Mok | Erl 150 mg/day plus (Gem 1,250 mg/m2 D1,8 and either Cis75 mg/m2 D1 or Car AUC = 5, D1) (n=57) vs. Gem 1,250 mg/m2 D1,8 and either (n=57) | first-line treatment for advanced non-small-cell lung cancer | Sample size: 57/57 Primary endpoint: FU duration: | SATURN (Cappuzzo) | Erl 150 mg/day plus select one of seven standard chemotherapy regimens (n=438) vs. Cis75 mg/m2 D1 or Car AUC = 5, D1 (n=451) | maintenance treatment in advanced non-small-cell lung cancer | Sample size: 438/451 Primary endpoint: FU duration: | Boutsikou | Erl 150 mg/day plus (Doc 100 mg/ m 2 and Car AUC = 5.5 q28d*4) (n=52) vs. Doc 100 mg/m2 and Car AUC = 5.5 q28d*4 (n=61) | first-line treatment of patients with NSCLC | Sample size: 52/61 Primary endpoint: FU duration: | Lee | Erl 150 mg/day plus Pem 500 mg/ m 2 D1 q21d (n=78) vs. Pem 500 mg/m2 D1 q21d (n=80) | second-line treatment for never-smokers with non-squamous non-small cell lung cancer | Sample size: 78/80 Primary endpoint: progression-free survival FU duration: | Stinchcombe | Erl 150 mg/day plus Gem 1,200 mg/m2 D1,8 q21d (n=51) vs. Gem 1,200 mg/m2 D1,8 q21d (n=44) | elderly patients (age ¡Ý70 years) with stage IIIB or IV non-small cell lung cancer | Sample size: 51/44 Primary endpoint: progression-free survival FU duration: | FASTACT-2 (Wu) | Erl 150 mg/day plus Gem 1,250 mg/m2 D1,8, six cycles and Car AUC = 5 or Cis 75 mg/ m 2,D1 (n=226) vs. Gem 1,250 mg/m2, d1,8, six cycles and Car AUC = 5 or Cis 75 mg/ m 2,D1 (n=255) | patients with untreated stage IIIB/IV non-small-cell lung cancer | Sample size: 226/255 Primary endpoint: FU duration: |
|
EGFR inhibitors | gefitinib | versus No demonstrated result for efficacy gefitinib inferior to in terms of PFS in CTONG0806 (Yang), 2013 | 26 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
ISTANA (Lee), 2010 | gefitinib vs docetaxel | ORR 3.69 [1.59; 8.58] | | OS 0.87 [0.61; 1.24] PFS 0.73 [0.53; 1.00] | V-15-32 (Maruyama), 2008 | gefitinib vs docetaxel | ORR 1.77 [1.18; 2.65] | | OS 1.12 [0.89; 1.40] PFS 0.90 [0.72; 1.12] | INTEREST (Kim), 2008 | gefitinib vs docetaxel | | | OS 1.01 [0.90; 1.14] PFS 1.04 [0.92; 1.17] ORR 1.20 [0.84; 1.72] | SIGN (Cufer), 2006 | gefitinib vs docetaxel | | | OS 0.97 [0.61; 1.53] PFS 0.94 [0.64; 1.39] ORR 0.97 [0.42; 2.24] | IPASS | gefitinib vs carboplatin/paclitaxel | | | | West Japan | gefitinib vs | | | | Northeast Japan | gefitinib vs | | | | First Signal | gefitinib vs gemcitabine and cisplatin | | | | Kris, 2003 | gefitinib vs gefitinib | | | | INTACT 1. | gefitinib + gemcitabine/cisplatin vs placebo + gemcitabine / cisplatin | | | | INTACT 2, 2004 | gefitinib paclitaxel and carboplatin vs paclitaxel and carboplatin | | | | CTONG0806 (Yang), 2013 | gefitinib vs | | PFS 1.96 [1.38; 2.79] | | NCIC CTG BR19 (Goss), 2013 | gefitinib vs placebo | | | | NEJ002, 2013 | gefitinib vs carboplatin-paclitaxel | | | | INFORM; C-TONG 0804, 2012 | gefitinib vs placebo | | | | EORTC 08021/ILCP 01/03, 2011 | gefitinib vs placebo | | | | Maemondo, 2010 | gefitinib vs carboplatin-paclitaxel | | | | IFCT-0301 study (Morère), 2010 | gefitinib vs docetaxel | | | | WJTOG0203 (Takeda), 2010 | gefitinib vs continued platinum-doublet chemotherapy | | | | WJTOG3405 (Mitsudomi), 2010 | gefitinib vs cisplatin plus docetaxel | | | | IPASS (Mok), 2009 | gefitinib vs carboplatin-paclitaxel | | | | Goss, 2009 | gefitinib vs placebo | | | | INVITE (Crinò), 2008 | gefitinib vs vinorelbine | | | | SWOG S0023 (Kelly), 2008 | gefitinib vs placebo | | | | ISEL, 2006 | gefitinib vs placebo | | | | Tsuboi, 2005 | gefitinib vs placebo | | | |
Trial | Treatments | Patients | Method |
---|
ISTANA (Lee), 2010 | (n=-9) vs. (n=-9) | previously treated advanced nonsmall-cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: | V-15-32 (Maruyama), 2008 | (n=-9) vs. (n=-9) | previously treated advanced nonsmall-cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: | INTEREST (Kim), 2008 | (n=-9) vs. (n=-9) | previously treated advanced nonsmall-cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: | SIGN (Cufer), 2006 | (n=-9) vs. (n=-9) | previously treated advanced nonsmall-cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: | IPASS | (n=-9) vs. (n=-9) | previously untreated never-smokers and light ex-smokers with advanced pulmonary adenocarcinoma | Sample size: -9/-9 Primary endpoint: FU duration: | West Japan | (n=-9) vs. (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: | Northeast Japan | (n=-9) vs. (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: | First Signal | gefitinib (250 mg daily) (n=159) vs. GP chemotherapy (gemcitabine 1,250 mg/m(2) on days 1 and 8; cisplatin 80 mg/m(2) on day 1 every 3 weeks, for up to nine courses (n=150) | first-line therapy of never-smokers with adenocarcinoma of the lung | Sample size: 159/150 Primary endpoint: FU duration: | Kris, 2003 | (n=-9) vs. (n=-9) | Patients either stage IIIB or IV NSCLC for which they had received at least 2 chemotherapy regimens | double blind Sample size: -9/-9 Primary endpoint: FU duration: | INTACT 1. | gefitinib 500 mg/d, gefitinib 250 mg/d, (n=-9) vs. placebo (n=-9) | chemotherapy-naive patients with unresectable stage III or IV NSCLC | double blind Sample size: -9/-9 Primary endpoint: FU duration: | INTACT 2, 2004 | gefitinib plus paclitaxel and carboplatin (n=-9) vs. paclitaxel 225 mg/m(2) and carboplatin area under concentration/time curve of 6 mg/min/mL (day 1 every 3 weeks) (n=-9) | chemotherapy-naive patients with advanced NSCLC | double-blind Sample size: -9/-9 Primary endpoint: FU duration: | CTONG0806 (Yang), 2013 | (n=-9) vs. (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: | NCIC CTG BR19 (Goss), 2013 | gefitinib 250 mg per day (n=-9) vs. placebo (n=-9) | completely resected non-small-cell lung cancer | double-blind Sample size: -9/-9 Primary endpoint: FU duration: | NEJ002, 2013 | (n=-9) vs. (n=-9) | chemo-naïve non-small cell lung cancer with sensitive EGFR gene mutations | Sample size: -9/-9 Primary endpoint: FU duration: | INFORM; C-TONG 0804, 2012 | (n=-9) vs. (n=-9) | maintenance therapy in patients with locally advanced or metastatic non-small-cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: | EORTC 08021/ILCP 01/03, 2011 | (n=-9) vs. (n=-9) | patients with advanced NSCLC, non-progressing after first line platinum-based chemotherapy | Sample size: -9/-9 Primary endpoint: FU duration: | Maemondo, 2010 | (n=-9) vs. (n=-9) | patients with metastatic, non-small-cell lung cancer and EGFR mutations who had not previously received chemotherapy | Sample size: -9/-9 Primary endpoint: FU duration: | IFCT-0301 study (Morère), 2010 | (n=-9) vs. (n=-9) | patients with advanced non-small-cell lung cancer and a performance status of 2 or 3 | Sample size: -9/-9 Primary endpoint: FU duration: | WJTOG0203 (Takeda), 2010 | (n=-9) vs. (n=-9) | Japanese patients with advanced non-small-cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: | WJTOG3405 (Mitsudomi), 2010 | (n=-9) vs. (n=-9) | patients with non-small-cell lung cancer harbouring mutations of the epidermal growth factor receptor | Sample size: -9/-9 Primary endpoint: FU duration: | IPASS (Mok), 2009 | (n=-9) vs. (n=-9) | previously untreated patients in East Asia who had advanced pulmonary adenocarcinoma and who were nonsmokers or former light smokers | Sample size: -9/-9 Primary endpoint: FU duration: | Goss, 2009 | (n=-9) vs. (n=-9) | chemotherapy-naive patients with advanced non-small-cell lung cancer and poor performance status | Sample size: -9/-9 Primary endpoint: FU duration: | INVITE (Crinò), 2008 | (n=-9) vs. (n=-9) | chemotherapy-naive elderly patients with advanced non-small-cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: | SWOG S0023 (Kelly), 2008 | (n=-9) vs. (n=-9) | inoperable stage III non-small-cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: | ISEL, 2006 | (n=-9) vs. (n=-9) | patients of Asian origin with refractory advanced non-small cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: | Tsuboi, 2005 | (n=-9) vs. (n=-9) | patients with completely resected non-small cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: |
|
EGFR inhibitors | osimertinib | versus No demonstrated result for efficacy osimertinib inferior to placebo in terms of ORR in FLAURA, 2017 (1L patients) | 2 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
AURA 3, 2017 | osimertinib vs platinum-based therapy plus pemetrexed | PFS 0.30 [0.22; 0.40] | | | FLAURA, 2017 | osimertinib vs placebo | PFS 0.45 [0.36; 0.56] | ORR 0.63 [0.45; 0.88] | |
Trial | Treatments | Patients | Method |
---|
AURA 3, 2017 | oral osimertinib (at a dose of 80 mg once daily) (n=-9) vs. intravenous pemetrexed (500 mg per square meter of body-surface area) plus either carboplatin (target area under the curve, 5 [AUC5]) or cisplatin (75 mg per square meter) every 3 weeks for up to six cycles (n=-9) | patients with EGFR T790M mutation-positive, locally-advanced or metastatic NSCLC, whose disease had progressed after 1st-line EGFR tyrosine kinase inhibitor (TKI) therapy. | Sample size: -9/-9 Primary endpoint: FU duration: | FLAURA, 2017 | osimertinib (AZD9291) (80 mg or 40 mg orally, once daily) (n=279) vs. first-line standard-of-care treatment erlotinib or gefitinib (n=277) | previously untreated patients with locally advanced or metastatic epidermal growth factor receptor (EGFR) mutation–positive non–small cell lung cancer | double-blind Parallel groups Sample size: 279/277 Primary endpoint: PFS FU duration: crossover permitted |
|
immune checkpoint inhibition | atezolizumab | versus standard of care No demonstrated result for efficacy | 4 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
POPLAR Phase 2 atezolizumab, 2016 | atezolizumab vs docetaxel | | | overall survival 0.73 [0.53; 1.00] median 12.6 mo vs. 9.7 mo | OAK, 2016 | atezolizumab vs docetaxel | overall survival 0.73 [0.62; 0.86] median 13.8 mo vs. 9.6 mo | | PFS 0.95 [0.82; 1.10] | IMpower150 (WT), 2018 | atezolizumab + bevacizumab vs bevacizumab (on top platinum-based CT) | PFS 0.62 [0.52; 0.74] median 8.3 mo vs. 6.8 mo | | ORR 1.01 [0.99; 1.02] | IMpower150 (Teff), 2018 | atezolizumab + bevacizumab vs bevacizumab (on top platinum-based CT) | PFS 0.51 [0.38; 0.68] median 11.3 mo vs. 6.8 mo | | ORR 1.00 [0.97; 1.03] |
Trial | Treatments | Patients | Method |
---|
POPLAR Phase 2 atezolizumab, 2016 | Atezolizumab (n=144) vs. docetaxel 75 mg/m(2) once every 3 weeks (n=143) | patients with locally Advanced or Metastatic Non-Small Cell Lung Cancer Who Have Failed Platinum Th | open label Parallel groups Sample size: 144/143 Primary endpoint: OS FU duration: phase 2 | OAK, 2016 | atelozumab (n=425) vs. docetaxel (n=425) | Patients With Locally Advanced or Metastatic Non-Small Cell Lung Cancer Who Have Failed Platinum Therapy | open label Parallel groups Sample size: 425/425 Primary endpoint: OS FU duration: minimum 19 months | IMpower150 (WT), 2018 | atezo + bev + C + P; (n=356) vs. bev + C + P (n=336) 3 arms : atezo 1200 mgþC AUC 6þP 200 mg/m2 (Arm A)
or atezo
þbev 15 mg/kg þC þ P (Arm B)
versus bev þ C þP (Arm C) IV q3w for 4 or 6 cycles per
investigator (INV) discretion,
then maintenance atezo, atezo þ bev or bev, respectively. | wild type chemotherapy-naïve patients with Stage IV non-squamous non-small cell lung cancer (EGFR et ALK negative) | open label Parallel groups Sample size: 356/336 Primary endpoint: PFS, OS FU duration: | IMpower150 (Teff), 2018 | atezo + bev + C + P
(n=155) vs. bev + C + P
(n=129) 3 arms : atezo 1200 mgþC AUC 6þP 200 mg/m2 (Arm A)
or atezo
þbev 15 mg/kg þC þ P (Arm B)
versus bev þ C þP (Arm C) IV q3w for 4 or 6 cycles per
investigator (INV) discretion,
then maintenance atezo, atezo þ bev or bev, respectively.
| chemotherapy-naïve patients with Stage IV non-squamous non-small cell lung cancer and expression of a tumour T-effector gene signature (Teff) and EGFR et ALK negative (wild type)
| open label Parallel groups Sample size: 155/129 Primary endpoint: PFS, OS FU duration:
|
|
immune checkpoint inhibition | durvalumab | versus No demonstrated result for efficacy | 1 trial | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
ARCTIC PD-L1 negative, 2018 | durvalumab + tremelimumab vs Standard of Care | | | |
Trial | Treatments | Patients | Method |
---|
ARCTIC PD-L1 negative, 2018 | combination of MEDI4736 (durvalumab) plus tremelimumab (n=-9) vs. Standard of Care
(n=-9)
| patients with PD-L1 negative Locally Advanced or Metastatic Non Small Cell Lung Cancer who have received at least 2 prior systemic treatment regimens including 1 platinum-based chemotherapy regimen for NSCLC
| Sample size: -9/-9 Primary endpoint: Overall Survival , FU duration:
|
|
immune checkpoint inhibition | durvalumab | versus placebo durvalumab superior to placebo in terms of PFS in PACIFIC, 2017 (maintenance patients) | 1 trial | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
PACIFIC, 2017 | durvalumab vs placebo | PFS 0.52 [0.42; 0.65] median 16.8 mo vs. 5.6 mo Demonstrated | | |
Trial | Treatments | Patients | Method |
---|
PACIFIC, 2017 | Durvalumab (at a dose of 10 mg per kilogram of body weight intravenously) every 2 weeks for up to 12 months, administered 1 to 42 days after the patients had received chemoradiotherapy (n=473) vs. placebo (n=236) | patients with stage III NSCLC who did not have disease progression after two or more cycles of platinum-based chemoradiotherapy | double-blind Parallel groups Sample size: 473/236 Primary endpoint: PFS, OS FU duration: |
|
immune checkpoint inhibition | ipilimumab | versus No demonstrated result for efficacy | 3 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
Reck, 2016 | ipilimumab + chemotherapy vs placebo + chemotherapy | | | | Govindan, 2017 | ipilimumab + chemotherapy vs placebo + chemotherapy | | | OS 0.91 [0.77; 1.07] median 13.4 mo vs. 12.4 mo | phase 2 (phased ipilimumab), 2012 | ipilimumab + chemotherapy vs placebo + chemotherapy | | | |
Trial | Treatments | Patients | Method |
---|
Reck, 2016 | ipilimumab 10 mg/kg plus etoposide and platinum (cisplatin or carboplatin) (n=478) vs. placebo plus etoposide and platinum (cisplatin or carboplatin) (n=476) | patients with newly diagnosed extensive-stage disease SCLC | double-blind Parallel groups Sample size: 478/476 Primary endpoint: FU duration: | Govindan, 2017 | ipilimumab 10 mg/kg + paclitaxel and carboplatin (n=388) vs. placebo + paclitaxel and carboplatin (n=361) | Patients with stage IV or recurrent chemotherapy-naïve squamous NSCLC | double-blind Parallel groups Sample size: 388/361 Primary endpoint: OS FU duration: | phase 2 (phased ipilimumab), 2012 | concurrent ipilimumab (four doses of ipilimumab plus paclitaxel and carboplatin followed by two doses of placebo plus paclitaxel and carboplatin) or phased ipilimumab (two doses of placebo plus paclitaxel and carboplatin followed by four doses of ipilimum (n=204) vs. paclitaxel (175 mg/m(2)) and carboplatin (area under the curve, 6) (n=0) | Patients with chemotherapy-naive non-small-cell lung cancer | double-blind Parallel groups Sample size: 204/0 Primary endpoint: immune-related progression-free survival FU duration: |
|
immune checkpoint inhibition | nivolumab | versus No demonstrated result for efficacy | 1 trial | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
CheckMate 227 (nivolumab + CT), 2018 | nivolumab + CT vs platinum-based CT | PFS 0.74 [0.58; 0.94] median 5.6 vs. 4.7 | | |
Trial | Treatments | Patients | Method |
---|
CheckMate 227 (nivolumab + CT), 2018 | Nivolumab + chemotherapy (n=177) vs. chemotherapy (n=186) 4 arms: Nivolumab, or Nivolumab Plus Ipilimumab, or Nivolumab Plus Platinum-doublet Chemotherapy, Compared to Platinum Doublet Chemotherapy
| Subjects With Chemotherapy-Naïve Stage IV or Recurrent Non-Small Cell Lung Cancer <1% tumor PD-L1 expression
| No masking Sample size: 177/186 Primary endpoint: Overall survival (OS) FU duration:
|
|
immune checkpoint inhibition | nivolumab | versus standard of care No demonstrated result for efficacy | 4 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
CheckMate 057, 2015 | nivolumab vs docetaxel | overall survival 0.73 [0.59; 0.90] median 12.2 mo vs. 9.4 mo grade 3–5 drug-related AEs 0.19 [0.14; 0.28] | | PFS 0.92 [0.77; 1.10] median 2.3 mo vs. 4.2 mo | CheckMate 026, 2016 | nivolumab vs platinum-based CT | | | overall survival 1.02 [0.80; 1.30] median 14.4 mo vs. 13.2 mo PFS 1.15 [0.91; 1.45] median 4.2 mo vs. 5.9 mo | CheckMate 017, 2015 | nivolumab vs docetaxel | overall survival 0.59 [0.44; 0.79] median 9.2 mo vs. 6.0 mo PFS 0.62 [0.47; 0.81] median 3.5 mo vs. 2.8 mo ORR 2.28 [1.21; 4.32] grade 3–5 drug-related AEs 0.12 [0.07; 0.24] | | Endocrine disorders ∞ [NaN; ∞] Hypothyroidism ∞ [NaN; ∞] Pneumonitis or interstitial lung disease 6.89 [0.86; 55.24] Severe skin reactions 1.07 [0.49; 2.35] Colitis ∞ [NaN; ∞] | CheckMate 227 (High Tumor Mutational Burden), 2018 | nivolumab + ipilimumab vs platinum-based CT | PFS 0.58 [0.41; 0.82] median 7.2 mo vs. 5.5 mo | | |
Trial | Treatments | Patients | Method |
---|
CheckMate 057, 2015 | Nivolumab 3 mg/kg solution intravenously every 2 weeks until documented disease progression (n=292) vs. Docetaxel 75 mg/m² concentrate for solution for intravenous infusion every 3 weeks until documented disease progression (n=290) | patients with advanced nonsquamous nonsmall cell lung cancer (NSCLC) who had progressed on platinum-doublet chemotherapy | open Parallel groups Sample size: 292/290 Primary endpoint: OS FU duration: | CheckMate 026, 2016 | Nivolumab solution for Injection 3 mg/kg Intravenous every 2 weeks until disease progression (n=271) vs. platinum-based chemotherapy (administered once every 3 weeks for up to six cycles). (n=270) Patients who progressed on chemotherapy could crossover to nivolumab as second line treatment.
| patients with previously untreated advanced non-small cell lung cancer (NSCLC) whose tumors expressed PD-L1 at >5% (>1%???). Patients with EGFR activating mutations and ALK translocations, which are sensitive to targeted therapy, were excluded.
| open design Parallel groups Sample size: 271/270 Primary endpoint: PFS FU duration: cross over were permitted, a total of 128 of 212 patients
(60%) in the chemotherapy group received nivolumab as subsequent therapy | CheckMate 017, 2015 | Nivolumab 3 mg/kg solution intravenously every 2 weeks until documented disease progression (n=135) vs. Docetaxel 75 mg/m2 solution intravenously every 3 weeks until documented disease progression (n=137) | patients with advanced SQ NSCLC who fail platinum-based doublet chemotherapy | open Sample size: 135/137 Primary endpoint: OS FU duration: | CheckMate 227 (High Tumor Mutational Burden), 2018 | nivolumab plus ipilimumab (n=139) vs. chemotherapy (n=160) 4 arms: Nivolumab, or Nivolumab Plus Ipilimumab, or Nivolumab Plus Platinum-doublet Chemotherapy, Compared to Platinum Doublet Chemotherapy | patients with stage IV or recurrent NSCLC that was not previously treated
with chemotherapy and high tumor mutational burden (>=10 mutations
per megabase), irrespective of PD-L1 expression level Tumor mutational burden was determined by the FoundationOne CDx assay | No masking Parallel groups Sample size: 139/160 Primary endpoint: PFS, OS FU duration: |
|
immune checkpoint inhibition | pembrolizumab | versus No demonstrated result for efficacy | 3 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
Keynote 407, 2018 | pembrolizumanb + CT vs platinum-based CT | overall survival 0.64 [0.49; 0.84] median 15.9 mo vs. 11.2 mo | | | Keynote 042 (>=50%), 2018 | pembrolizumab vs platinum-based CT | overall survival 0.69 [0.56; 0.85] median 20.0 mo vs. 12.2 mo | | | Keynote 042 (>=20%), 2018 | pembrolizumab vs platinum-based CT | overall survival 0.77 [0.64; 0.92] median 17.7 mo vs. 13.0 mo | | |
Trial | Treatments | Patients | Method |
---|
Keynote 407, 2018 | pembrolizumab + carboplatin and paclitaxel or nano particle albumin-bound paclitaxel (nab-paclitaxel) (n=278) vs. carboplatin and paclitaxel or nano particle albumin-bound paclitaxel (nab-paclitaxel) (n=281) | adults with first line metastatic squamous non-small cell lung cancer | open-label Parallel groups Sample size: 278/281 Primary endpoint: OS, PFS FU duration: 7?7 mo (median) | Keynote 042 (>=50%), 2018 | pembrolizumab
(n=299) vs. SOC Treatment (Platinum-based Chemotherapy)
(n=300)
| Treatment Naïve Subjects With PD-L1 Positive Advanced or Metastatic Non-Small Cell Lung Cancer
| open label Sample size: 299/300 Primary endpoint: Overall survival FU duration: 12.8-mo median
| Keynote 042 (>=20%), 2018 | pembrolizumab
(n=413) vs. SOC Treatment (Platinum-based Chemotherapy)
(n=405)
| Treatment Naïve Subjects With PD-L1 Positive Advanced or Metastatic Non-Small Cell Lung Cancer
| open label Parallel groups Sample size: 413/405 Primary endpoint: Overall survival FU duration: 12.8-mo median
|
|
immune checkpoint inhibition | pembrolizumab | versus standard of care pembrolizumab + platinum-based CT superior to platinum-based CT in terms of overall survival in Keynote 189, 2018 (1L PD-L1 positive nonsquamous patients) pembrolizumab + platinum-based CT superior to platinum-based CT in terms of PFS in Keynote 189, 2018 (1L PD-L1 positive nonsquamous patients) | 6 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
Keynote 042 (>=1%), 2018 | pembrolizumab vs platinum-based CT | overall survival 0.81 [0.71; 0.93] median 16.7 mo vs. 12.1 mo | | | Keynote 024, 2015 | pembrolizumab vs platinum-based CT | overall survival 0.60 [0.41; 0.88] median not reached vs. not reached PFS 0.50 [0.37; 0.68] median 10.3 mo vs. 6.0 mo | | | Keynote 010 2mg, 2015 | pembrolizumab 2mg vs docetaxel | overall survival 0.71 [0.58; 0.87] median 10.4 mo vs. 8.5 mo | | PFS 0.88 [0.74; 1.05] median 3.9 mo vs. 4.0 mo | Keynote 010 10mg, 2015 | pembrolizumab 10mg vs docetaxel | overall survival 0.61 [0.49; 0.75] median 12.7 mo vs. 8.5 mo PFS 0.79 [0.66; 0.94] median 4.0 mo vs. 4.0 mo | | | KEYNOTE-021 phase 2, 2016 | pembrolizumab + platinum-based CT vs platinum-based CT | overall survival 0.54 [0.33; 0.88] median 19 mo vs. 8.9 mo PFS 0.53 [0.31; 0.91] median 13.0 mo vs. 8.9 mo | | | Keynote 189, 2018 | pembrolizumab + platinum-based CT vs platinum-based CT | overall survival 0.49 [0.38; 0.64] median 11.3 mo vs. not reached Demonstrated PFS 0.52 [0.43; 0.63] median 8.8 mo vs. 4.9 mo Demonstrated | | |
Trial | Treatments | Patients | Method |
---|
Keynote 042 (>=1%), 2018 | pembrolizumab 200 mg every 3 wk for 35 cycles or until disease progression, intolerable toxicity (n=637) vs. investigator's choice of carboplatin plus paclitaxel or carboplatin plus pemetrexed for a maximum of 6 cycles (n=637) | Treatment Naïve Subjects With PD-L1 Positive Advanced or Metastatic Non-Small Cell Lung Cancer | open label Parallel groups Sample size: 637/637 Primary endpoint: Overall survival FU duration: 12.8-mo median | Keynote 024, 2015 | Pembrolizumab (200 mg, administered as intravenous (IV) infusion on Day 1 of each 21-day cycle for up to 35 cycles or until documented PD
(n=154) vs. standard of care (SOC) platinum-based chemotherapies
(n=151) crossover from the chemotherapy group to the pembrolizumab group was permitted in
the event of disease progression
| previously
untreated advanced NSCLC with PD-L1 expression on at least 50% of tumor cells
and no sensitizing mutation of the epidermal growth factor receptor gene or translocation
of the anaplastic lymphoma kinase gene | open label Parallel groups Sample size: 154/151 Primary endpoint: PFS, OS FU duration: 11.2 months (median) in the chemotherapy group,
66 patients (43.7%) crossed over to receive pembrolizumab
after disease progression
| Keynote 010 2mg, 2015 | pembrolizumab
2 mg/kg (n=345) vs. docetaxel 75 mg/m² every 3 weeks (n=343) | patients
with previously treated non-small-cell lung cancer with PD-L1 expression on at least 1% of tumour cells | open-label Parallel groups Sample size: 345/343 Primary endpoint: OS FU duration: | Keynote 010 10mg, 2015 | pembrolizumab
10 mg/kg
(n=346) vs. docetaxel 75 mg/m² every 3 weeks
(n=343)
| patients
with previously treated non-small-cell lung cancer with PD-L1 expression on at least 1% of tumour cells
| open-label Sample size: 346/343 Primary endpoint: OS FU duration:
| KEYNOTE-021 phase 2, 2016 | 24 months treatment with pembrolizumab (200mg every three weeks)+ CT (n=60) vs. four cycles of carboplatin and pemetrexed (500 mg/m2 every three weeks) (n=63) | patients with stage IIIB/IV, chemotherapy-naive, nonsquamous non-small-cell lung cancer | open design Parallel groups Sample size: 60/63 Primary endpoint: ORR FU duration: phase 1/2 | Keynote 189, 2018 | pemetrexed
and a platinum-based drug plus 200 mg of pembrolizumab, followed by pembrolizumab for up to a total of
35 cycles plus pemetrexed maintenance therapy (n=410) vs. pemetrexed
and a platinum-based drug plus placebo every
3 weeks for 4 cycles, followed by placebo (n=206) | participants with advanced or metastatic nonsquamous non-small cell lung cancer (NSCLC) who have not previously received systemic therapy for advanced disease and without sensitizing EGFR or ALK mutations | double-blind Parallel groups Sample size: 410/206 Primary endpoint: PFS, OS FU duration: 10.5 mo median crossover permited |
|
Taxanes | docetaxel | versus No demonstrated result for efficacy | 9 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
DISTAl 01 (Gridelli) , 2004 | weekly docetaxel vs 3-weekly docetaxel | | | | Camps | weekly docetaxel vs 3-weekly docetaxel | | | | Schuette | weekly docetaxel vs 3-weekly docetaxel | | | | Gervais | weekly docetaxel vs 3-weekly docetaxel | | | | Lai | weekly docetaxel vs 3-weekly docetaxel | | | | Chen | weekly docetaxel vs 3-weekly docetaxel | | | | TAX 317 (Shepherd) 100mg/m2, 2000 | docetaxel vs | | | | TAX 320 100mg/m2, 2000 | docetaxel vs | | | | Esteban, 2003 | paclitaxel 80mg/m2 vs m2docetaxel 36 mg/ | | | |
Trial | Treatments | Patients | Method |
---|
DISTAl 01 (Gridelli) , 2004 | (n=220) vs. (n=0) | patients with advanced NSCLC patients, < or =75 years, ECOG PS < or =2 | Sample size: 220/0 Primary endpoint: FU duration: | Camps | docetaxel 36 mg/m(2) given weekly (1W arm) for 6 weeks followed by 2 weeks of rest (n=-9) vs. docetaxel 75 mg/m(2) administered every 3 weeks (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: | Schuette | (n=-9) vs. (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: | Gervais | (n=-9) vs. (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: | Lai | (n=-9) vs. (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: | Chen | (n=-9) vs. (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: | TAX 317 (Shepherd) 100mg/m2, 2000 | docetaxel 100 mg/m(2) (n=-9) vs. best supportive care (n=-9) 3 arms: docetaxel 100 mg/m(2), 75 mg/m(2), best supportive care | Patients with performance statuses of 0 to 2 and stage IIIB/IV non-small-cell lung cancer | Sample size: -9/-9 Primary endpoint: FU duration: | TAX 320 100mg/m2, 2000 | docetaxel 100 mg/m(2) (D100) or 75 mg/m(2) (D75) (n=373) vs. control regimen of vinorelbine or ifosfamide (n=0) 3 arms : docetaxel 100 mg/m(2) (D100), docetaxel 75 mg/m(2) (D75), control | patients with advanced non-small-cell lung cancer who had previously failed platinum-containing chemotherapy | Sample size: 373/0 Primary endpoint: FU duration: | Esteban, 2003 | paclitaxel 80 mg/m2 as a 1 h weekly infusion for 6 weeks
followed by a 2-week rest (n=36) vs. docetaxel 36 mg/m2 as a 1 h weekly infusion for 6 weeks
followed by a 2-week rest. (n=35) | patients with NSCLC previously treated with platinum-based
chemotherapy | Sample size: 36/35 Primary endpoint: FU duration: |
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