DDRE-04. EFFECTIVENESS AND SAFETY OF OSIMERTINIB FOR PATIENTS WITH LEPTOMENINGEAL METASTASES FORM NON-SMALL CELL LUNG CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract BACKGROUND the FLAURA study established Osimertinib to be the priority choice for the treatment of metastatic non-small cell lung cancer (NSCLC) harboring mutated epidermal growth factor receptor (EGFR). However, like many previous studies, the FLAURA study excluded patients with symptomatic CNS metastases. Hence, we performed a systematic review and meta-analyses of studies to assess the efficiency and safety of Osimertinib for the treatment of NSCLC with leptomeningeal metastases (LM). METHODS We included studies published between 2010 and 2021 that evaluated the efficacy and toxicity of Osimertinib in NSCLC patients with LM. We searched PubMed, Embase, and oncology meeting abstracts (ASCO, ESMO and WCLC). Primary outcomes were objective response rate (ORR), disease control rate (DCR), any grade 3/4 toxicity rate. We used the random-effects model to generate pooled estimates for proportions. Newcastle-Ottawa Scale (NOS) was used to assess the certainty in the evidence. RESULTS Twelve studies reporting on 367 patients were included in the meta-analysis. Most patients (≥90%) received Osimertinib as at least second line of treatment. The objective response rate was 42% (95% CI, 24%-59%; n = 184), and CNS disease control rate was 90% (95% CI, 85%-94%; n = 154). Intracranial progression free survival and overall survival ranged from 3.7 to 15.6 months, and 11.0 to 18.8 months, respectively. Adverse events were similar with previous studies and Common Terminology Criteria for Adverse Events (version 3.0) grade 3 or higher adverse event rates was acceptable. CONCLUSION This meta-analysis confirmed that for advanced NSCLC with LM harboring EGFR-TKI-sensitizing mutations, Osimertinib showed impressive antitumor activity and acceptable toxicity.

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Efficacy and Safety of Antigen-specific Immunotherapy in the Treatment of Patients with Non-small-cell Lung Cancer: A Systematic Review and Meta-analysis

Current Cancer Drug Targets ◽

10.2174/1568009618666180430124738 ◽

2019 ◽

Vol 19 (3) ◽

pp. 199-209 ◽

Cited By ~ 1

Author(s):

Bing-Di Yan ◽

Xiao-Feng Cong ◽

Sha-Sha Zhao ◽

Meng Ren ◽

Zi-Ling Liu ◽

...

Keyword(s):

Lung Cancer ◽

Systematic Review ◽

Adverse Events ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Specific Immunotherapy ◽

Meta Analysis ◽

Small Cell ◽

Efficacy And Safety ◽

Small Cell Lung

Background and Objective: We performed this systematic review and meta-analysis to assess the efficacy and safety of antigen-specific immunotherapy (Belagenpumatucel-L, MAGE-A3, L-BLP25, and TG4010) in the treatment of patients with non-small-cell lung cancer (NSCLC). Methods: A comprehensive literature search on PubMed, Embase, and Web of Science was conducted. Eligible studies were clinical trials of patients with NSCLC who received the antigenspecific immunotherapy. Pooled hazard ratios (HRs) with 95% confidence intervals (95%CIs) were calculated for overall survival (OS), progression-free survival (PFS). Pooled risk ratios (RRs) were calculated for overall response rate (ORR) and the incidence of adverse events. Results: In total, six randomized controlled trials (RCTs) with 4,806 patients were included. Pooled results showed that, antigen-specific immunotherapy did not significantly prolong OS (HR=0.92, 95%CI: 0.83, 1.01; P=0.087) and PFS (HR=0.93, 95%CI: 0.85, 1.01; P=0.088), but improved ORR (RR=1.72, 95%CI: 1.11, 2.68; P=0.016). Subgroup analysis based on treatment agents showed that, tecemotide was associated with a significant improvement in OS (HR=0.85, 95%CI: 0.74, 0.99; P=0.03) and PFS (HR=0.70, 95%CI: 0.49, 0.99, P=0.044); TG4010 was associated with an improvement in PFS (HR=0.87, 95%CI: 0.75, 1.00, P=0.058). In addition, NSCLC patients who were treated with antigen-specific immunotherapy exhibited a significantly higher incidence of adverse events than those treated with other treatments (RR=1.11, 95%CI: 1.00, 1.24; P=0.046). Conclusion: Our study demonstrated the clinical survival benefits of tecemotide and TG4010 in the treatment of NSCLC. However, these evidence might be limited by potential biases. Therefore, further well-conducted, large-scale RCTs are needed to verify our findings.

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Phase II study of docetaxel and cisplatin in advanced non-small-cell lung cancer.

Journal of Clinical Oncology ◽

10.1200/jco.1998.16.5.1948 ◽

1998 ◽

Vol 16 (5) ◽

pp. 1948-1953 ◽

Cited By ~ 60

Author(s):

J Zalcberg ◽

M Millward ◽

J Bishop ◽

M McKeage ◽

A Zimet ◽

...

Keyword(s):

Lung Cancer ◽

Phase Ii ◽

Advanced Nsclc ◽

Response Rate ◽

Phase Ii Study ◽

Performance Status ◽

Objective Response ◽

Small Cell ◽

Small Cell Lung ◽

Grade 3

PURPOSE Docetaxel (Taxotere, Rhone-Poulenc Rorer, Antony, France) and cisplatin are two of the most active single agents used in the treatment of non-small-cell lung cancer (NSCLC). A recently reported phase I study of the combination of docetaxel and cisplatin recommended a dose of 75 mg/m2 of both drugs every 3 weeks for subsequent phase II study. PATIENTS AND METHODS Eligible patients were aged 18 to 75 years with a World Health Organization (WHO) performance status < or = 2 and life expectancy > or = 12 weeks, with metastatic and/or locally advanced NSCLC proven histologically or cytologically. Patients were not permitted to have received prior chemotherapy, extensive radiotherapy, or any radiotherapy to the target lesion and must have had measurable disease. Concurrent treatment with colony-stimulating factors (CSFs) or prophylactic antibiotics was not permitted. Docetaxel (75 mg/m2) in 250 mL 5% dextrose was given intravenously (i.v.) over 1 hour immediately before cisplatin (75 mg/m2) in 500 mL normal saline given i.v. over 1 hour in 3-week cycles. Premedication included ondansetron, dexamethasone, promethazine, and standard hyperhydration with magnesium supplementation. RESULTS A total of 47 patients, two thirds of whom had metastatic disease, were entered onto this phase II study. The majority of patients were male (72%) and of good (WHO 0 to 1) performance status (85%). All 47 patients were assessable for toxicity and 36 were for response. Three patients were ineligible and eight (17%) discontinued treatment because of significant toxicity. In assessable patients, the overall objective response rate was 38.9% (95% confidence limits [CL], 23.1% to 56.5%), 36.1% had stable disease, and 25% progressive disease. On an intention-to-treat analysis, the objective response rate was 29.8%. Median survival was 9.6 months and estimated 1-year survival was 33%. Significant (grade 3/4) toxicities included nausea (26%), hypotension (15%), diarrhea (13%), and dyspnea mainly related to chest infection (13%). One patient experienced National Cancer Institute (NCI) grade 3 neurosensory toxicity after eight cycles. Grade 3/4 neutropenia was common and occurred in 87% of patients, but thrombocytopenia > or = grade 3 was rare (one patient). Significant (grade 3/4) abnormalities of magnesium levels were common (24%). Febrile neutropenia occurred in 13% of patients and neutropenic infection in 11%, contributing to two treatment-related deaths. No neutropenic enterocolitis or severe fluid retention was reported. CONCLUSION Compared with other active regimens used in this setting, the combination of docetaxel and cisplatin in advanced NSCLC is an active regimen with a similar toxicity profile to other combination regimens.

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A systematic review and meta-analysis of treatment-related toxicities of curative and palliative radiation therapy in non-small cell lung cancer

Scientific Reports ◽

10.1038/s41598-021-85131-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

M. Or ◽

B. Liu ◽

J. Lam ◽

S. Vinod ◽

W. Xuan ◽

...

Keyword(s):

Lung Cancer ◽

Systematic Review ◽

Decision Making ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Meta Analysis ◽

Small Cell ◽

Small Cell Lung ◽

Cardiac Events ◽

Grade 3

AbstractTreatment-related toxicity is an important component in non-small cell lung cancer (NSCLC) management decision-making. Our aim was to evaluate and compare the toxicity rates of curative and palliative radiotherapy with and without chemotherapy. This meta-analysis provides better quantitative estimates of the toxicities compared to individual trials. A systematic review of randomised trials with > 50 unresectable NSCLC patients, treated with curative or palliative conventional radiotherapy (RT) with or without chemotherapy. Data was extracted for oesophagitis, pneumonitis, cardiac events, pulmonary fibrosis, myelopathy and neutropenia by any grade, grade ≥ 3 and treatment-related deaths. Mantel–Haenszel fixed-effect method was used to obtain pooled risk ratio. Forty-nine trials with 8609 evaluable patients were included. There was significantly less grade ≥ 3 acute oesophagitis (6.4 vs 22.2%, p < 0.0001) and any grade oesophagitis (70.4 vs 79.0%, p = 0.04) for sequential CRT compared to concurrent CRT, with no difference in pneumonitis (grade ≥ 3 or any grade), neutropenia (grade ≥ 3), cardiac events (grade ≥ 3) or treatment-related deaths. Although the rate of toxicity increased with intensification of treatment with RT, the only significant difference between treatment regimens was the rate of oesophagitis between the use of concurrent and sequential CRT. This can aid clinicians in radiotherapy decision making for NSCLC.

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Disodium Cantharidinate and Vitamin B6 Injection Adjunct with Platinum-Based Chemotherapy for the Treatment of Advanced Non-Small-Cell Lung Cancer: A Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/9386273 ◽

2019 ◽

Vol 2019 ◽

pp. 1-14 ◽

Cited By ~ 1

Author(s):

Zhichao Wang ◽

Fanchao Feng ◽

Qi Wu ◽

Yihan Jin ◽

Cheng Gu ◽

...

Keyword(s):

Lung Cancer ◽

Objective Response Rate ◽

Vitamin B6 ◽

Response Rate ◽

Meta Analysis ◽

Objective Response ◽

Small Cell ◽

Karnofsky Performance Score ◽

Performance Score ◽

Small Cell Lung

Purpose. Disodium cantharidinate and vitamin B6 (DCVB6) injection is effective and widely used for the clinical treatment of non-small-cell lung cancer (NSCLC). This meta-analysis aimed to provide evidence-based medical data for clinical treatment with DCVB6 injection. Methods. We searched 7 medical databases up to January 2018 for all randomized controlled trials (RCTs) based on DCVB6 injection combined with chemotherapy in patients with NSCLC. A manual search in relevant journals and of relevant literature on other websites was also performed. Data extraction and quality assessment were conducted independently by two reviewers. Subsequently, a meta-analysis was conducted using RevMan 5.3 software. Pooled risk ratio (RR) with 95% confidence interval (CI) was used to evaluate dichotomous and continuous outcomes, respectively. The PROSPERO ID was CRD42018086377. Results. A total of 19 RCTs were included. The results of the meta-analysis indicated that the DCVB6 injection combined with chemotherapy was superior to chemotherapy alone regarding objective response rate (RR=1.58, 95% CI 1.40-1.79), Karnofsky performance score (RR=1.68, 95% CI 1.42-1.99), clinical symptom (RR=1.68, 95% CI 1.44-1.96), white blood cell toxicity (RR=0.36, 95% CI 0.27-0.49), platelet toxicity (RR=0.46, 95% CI 0.33-0.63), and vomiting (RR=0.50, 95% CI 0.37-0.67). Conclusions. The current evidence suggests that DCVB6 injection combined with chemotherapy could increase objective response rate and Karnofsky performance score, improve clinical symptoms, and reduce side effects caused by chemotherapy in patients with NSCLC. However, these results should be carefully interpreted due to the low-quality methodology and the small sample sizes of the trials, and our conclusions should be verified by high-quality, large-scale, double-blinded RCTs.

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Phase I/IIa Study of Cetuximab With Gemcitabine Plus Carboplatin in Patients With Chemotherapy-Naïve Advanced Non–Small-Cell Lung Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2004.00.1438 ◽

2005 ◽

Vol 23 (36) ◽

pp. 9089-9096 ◽

Cited By ~ 126

Author(s):

Francisco Robert ◽

George Blumenschein ◽

Roy S. Herbst ◽

Frank V. Fossella ◽

Jennifer Tseng ◽

...

Keyword(s):

Lung Cancer ◽

Overall Survival ◽

Adverse Events ◽

Tumor Response ◽

Response Rate ◽

Small Cell ◽

Toxicity Profile ◽

Time To Progression ◽

Small Cell Lung ◽

Grade 3

Purpose This multicenter, open-label, phase I/IIa study was undertaken to establish the safety/toxicity profile of cetuximab in combination with gemcitabine and carboplatin in patients with chemotherapy-naïve, epidermal growth factor receptor–positive, stage IV non–small-cell lung cancer. Secondary objectives were to gather preliminary evidence of efficacy including tumor response rate, time to progression, and overall survival. Patients and Methods Thirty-five patients received a total of 264 3-week cycles of treatment with cetuximab, carboplatin, and gemcitabine. An initial dose of cetuximab 400 mg/m2 intravenously was administered the first week, followed by weekly doses of 250 mg/m2. Carboplatin (area under the curve = 5, day 1) and gemcitabine 1,000 mg/m2 on days 1 and 8 were administered every 3 weeks. Patients were evaluated for tumor response after every two cycles of therapy. Results The most frequently reported adverse events related to cetuximab included an acne-like rash (88.6%), dry skin (34.3%), asthenia and skin disorders (31.4%), mucositis/stomatitis (25.7%), fever/chills (20%), and nausea/vomiting (17.1%). The majority of these toxicities were mild to moderate. One patient withdrew from the study because of a grade 3 allergic reaction. Myelosuppression was the most frequently observed toxicity related to chemotherapy. Responses among 35 assessable patients included 10 partial responses (28.6%). Twenty-one patients had stable disease. The median time to progression was 165 days, and the median overall survival was 310 days. Conclusion The combination of cetuximab, carboplatin, and gemcitabine was well tolerated with an acceptable toxicity profile. Most grade 3 adverse events were attributable to chemotherapy. The response rate and median survival are encouraging and warrant additional investigation.

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Phase 1b Study of Ramucirumab in Combination With Erlotinib or Osimertinib for Untreated EGFR-mutated Non–small Cell Lung Cancer Patients With Asymptomatic Brain Metastases

10.21203/rs.3.rs-533997/v1 ◽

2021 ◽

Author(s):

Hiroyasu Kaneda ◽

Kenji Sawa ◽

Haruko Daga ◽

Asuka Okada ◽

Yuki Nakatani ◽

...

Keyword(s):

Lung Cancer ◽

Adverse Events ◽

Brain Metastases ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Objective Response ◽

Small Cell ◽

Small Cell Lung ◽

Phase 1B ◽

Grade 3

Abstract Objectives: The study was designed to investigate the safety and tolerability of ramucirumab administered in combination with erlotinib or osimertinib for patients with untreated EGFR-mutated non–small cell lung cancer (NSCLC) and asymptomatic brain metastases, a patient subgroup in which these regimens have remained untested.Materials and methods: This multicenter phase 1b study (RELAY-Brain) consisted of two cohorts with three patients each. The two cohorts were assessed independently of one another and were not compared. Patients whose asymptomatic brain metastases had or had not undergone prior local therapy received ramucirumab (10 mg/kg) every 2 weeks plus either erlotinib (150 mg/day) or osimertinib (80 mg/day) until disease progression or intolerable toxicity. The primary objective of the study was to assess dose-limiting toxicity (DLT), defined as central nervous system (CNS) hemorrhage of grade ³2. Secondary end points included safety profile, objective response (systemic and intracranial), and disease control rate.Results: Six patients were enrolled in the study. Neither DLT nor serious or unexpected adverse events were observed. At the time of this analysis, discontinuation of the study drugs had also not occurred. One treatment-related adverse event of grade ³3 (hypertension of grade 3) was apparent. Common adverse events were generally manageable. The median number of ramucirumab administrations was 18.5 (range, 13 to 31), and there were no detected episodes of CNS hemorrhage. Four patients experienced at least one dose delay for ramucirumab, but there were no dose reductions or omissions for this drug. Five of the six patients showed an objective systemic response. Although only one patient had a measurable CNS lesion at baseline, a confirmed intracranial partial response was observed. Conclusion: Ramucirumab in combination with erlotinib or osimertinib showed promising safety and efficacy for EGFR-mutated NSCLC with brain metastases.Clinical trial registration: Japan Registry of Clinical Trials (jRCTs2051190027)

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Efficacy and safety of PD-1/PD-L1 antibody combined with chemotherapy as second-line or third-line treatment for metastatic small cell lung cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e20574 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e20574-e20574

Author(s):

Jun Wang ◽

Beibei Yin ◽

Yaping Guan ◽

Dongfeng Feng

Keyword(s):

Lung Cancer ◽

Response Rate ◽

Objective Response ◽

Small Cell ◽

Efficacy And Safety ◽

Small Cell Lung ◽

First Line ◽

Platinum Based Chemotherapy ◽

Extensive Stage ◽

Grade 3

e20574 Background: For a small subset of patients, immune checkpoint blockade heralds a promising strategy for achieving disease control in small cell lung cancer (SCLC). Nivolumab or pembrolizumab monotherapy has been granted accelerated approval for treatment of patients with extensive-stage SCLC with disease progression after platinum-based chemotherapy and at least one other line of therapy. Moreover, Based on IMpower133 and CASPIAN data, addition of PD-L1 antibody such as atezolizumab or durvalumab to first-line platinum-based chemotherapy prolongs overall survival over chemotherapy alone. However, it remains exclusive that whether PD-1/PD-L1 antibody combined with chemotherapy is effective against extensive-stage SCLC when progressed on previous chemotherapy. Methods: We reviewed patients with extensive-stage SCLC who have failed in first-line or beyond chemotherapy and received PD-1/PD-L1 antibodies with chemotherapy in a single institute. The efficacy and safety were evaluated. The primary end point was the objective response rate according to Response Evaluation Criteria in Solid Tumors, version 1.1. Results: A total of 11 patients were included in this retrospective cohort study. The median age was 46 years (range from 29 to 62). Seven patients were male. Four were current or former smokers. Six received two prior therapies. Nine had previously received radiation therapy. PD-1 and PD-L1 inhibitors were administrated in 5 and 6 patients, respectively. No patient had a complete response. 2 patients had a partial response, and the objective response rate was 18.2%. 5 patients were evaluated as stable disease with a disease control rate of 63.6%. The median overall survival and progression-free survival was 3.0 months and 2.3 months, respectively. A patient with partial response had a long duration of response of 5.2 months. The most common grade 3 or 4 treatment-related were neutropenia, anemia, and decreased neutrophil count. Most immune-related adverse events were grade 1 or 2, with rash, pruritus and hypothyroidism being the most common, and 1 patient had grade 3 pneumonia. Conclusions: Immunotherapy plus chemotherapy could be beneficial for a subgroup of extensive-stage SCLC patients who have progressed after previous chemotherapy. Further prospective, randomized studies are warranted.

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Fatal Adverse Events Associated With Immune Checkpoint Inhibitors in Non–small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Frontiers in Medicine ◽

10.3389/fmed.2021.627089 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xiaolin Yu ◽

Xiaomei Zhang ◽

Ting Yao ◽

Ye Zhang ◽

Yanxia Zhang

Keyword(s):

Lung Cancer ◽

Systematic Review ◽

Adverse Events ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Meta Analysis ◽

Small Cell ◽

Small Cell Lung ◽

Fatal Adverse Events

Background: Immune checkpoint inhibitors (ICIs) have previously been reported to have a promising potential in terms of the improvement of outcomes in non–small cell lung cancer (NSCLC). Fatal adverse events (FAEs) of ICIs are relatively uncommon, and the incidence and risk in NSCLC remain unclear. In the present study, we conducted a systematic review and meta-analysis to evaluate the risk of FAEs in NSCLC patients administered with ICIs.Methods: Potentially relevant studies were identified in PubMed, EMBASE, and Cochrane library database from inception to September 16, 2020. The systematic review and meta-analysis included randomized controlled trials that reported treatment-related FAEs in NSCLC. The pooled incidence and risk ratios (RRs) were calculated to evaluate prospective risk.Results: Twenty clinical trials that included a total of 13,483 patients were selected for the meta-analysis. The overall incidence of FAEs was 0.65% [95% confidence interval (CI) = 0.31–1.07, I2 = 50.2%] in ICI monotherapy, 1.17% (95% CI = 0.74–1.69, I2 = 56.3%) in chemotherapy, and 2.01% (95% CI = 1.42–2.69, I2 = 5.9%) in the combination therapy (ICI and chemotherapy). ICI monotherapy was associated with lower incidence of FAEs caused by blood system disorders (RR = 0.23, 95% CI = 0.07–0.73, P = 0.013, I2 = 0%) and infectious diseases (RR = 0.29, 95% CI = 0.13–0.63, P = 0.002, I2 = 0%). The incidence of pneumonitis significantly increased in immunotherapy (RR = 5.72, 95% CI = 1.14–28.80, P = 0.03, I2 = 0%).Conclusions: The results of the present study demonstrate that ICI monotherapy decreases the risk of FAEs, whereas the combined regimens with chemotherapy have the opposite tendency as compared to conventional chemotherapy. While the patients who received chemotherapy suffered the risks of death mainly from myelosuppression and infection, those who received immunotherapy were mainly threatened by immune-related pneumonitis.

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Atezolizumab Plus Chemotherapy Vs Chemotherapy Alone for Non-small Cell Lung Cancer: A Meta-analysis of Different PD-L1-expression Levels

10.21203/rs.3.rs-79433/v1 ◽

2020 ◽

Author(s):

Zhang Hong ◽

Zhong Xiaoyu ◽

Liu Zhaowei ◽

Miao Feifei ◽

Zhang Changgeng

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Meta Analysis ◽

Objective Response ◽

Progression Free Survival ◽

Small Cell ◽

Small Cell Lung ◽

Double Blind ◽

Grade 3

Abstract Background Atezolizumab was effective and well tolerated in pretreated non-small-cell lung cancer (NSCLC). This meta-analysis assessed that the efficacy and safety of atezolizumab plus chemotherapy combination, compared to chemotherapy alone.Methods This meta-analysis included double-blind randomized controlled trials (RCTs) comparing atezolizumab plus chemotherapy combination with chemotherapy alone for NSCLC. The subgroups were the high expression of PD-L1（PD-L1-high）, the low expression of PD-L1 （PD-L1-low） and the negative expression of PD-L1 (PD-L1-negative). The hazard ratios (HRs) and odds ratios (ORs) with 95% confidence interval (CI) were calculated. The outcome parameters were overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and adverse events Grade 3-5（AEs G3-5）.Results A total of 6 articles were included in this meta-analysis. The results indicated that atezolizumab plus chemotherapy combination had better efficacy than chemotherapy alone for PFS (HR=0.64, 95% CI=0.60 to 0.70,P<0.001), PFS（PD-L1-high）(HR=0.41, 95% CI=0.34 to 0.51,P<0.001), PFS（PD-L1-low）(HR=0.63,95% CI 0.55 to 0.72,P<0.001) and PFS（PD-L1-negative）(HR=0.71, 95% CI=0.61 to 0.83,P<0.001). There were statistically significant improvements in terms of OS (HR = 0.79, 95% CI = 0.73 to 0.86,P<0.001) 、OS (PD-L1-high) (HR = 0.65, 95% CI = 0.48 to 0.88,P<0.01) and OS (PD-L1-negative) (HR = 0.84, 95% CI = 0.72 to 0.98,P<0.05). Significant benefits were observed in ORR (OR=1.81,95% CI=1.58 to 2.08, P<0.001), ORR（PD-L1-high）(OR=2.24,95% CI=1.24 to 4.06,P<0.01), ORR（PD-L1-low）(OR=1.51,95% CI=1.03 to 2.21,P<0.05) and ORR（PD-L1-negative）(OR=1.54,95% CI=1.05 to 2.27,P<0.05). Meanwhile, atezolizumab was well tolerated and the incidence of AEs G3-5 (OR = 1.32, 95% CI = 1.06 to 1.64,P=0.01). Conclusion The atezolizumab plus chemotherapy combination had excellent efficacy and great safety than chemotherapy alone for NSCLC. Furthermore, these benefits had nothing to do with the state of PD-L1 expression.

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