Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer

非小细胞肺癌免疫疗法联合化疗的临床疗效和安全性荟萃分析

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Abstract

PURPOSE: This study aimed to assess the clinical effectiveness and safety of combining immunotherapy with chemotherapy for non-small cell lung cancer. METHODS: A comprehensive search of studies published until January 2024 was conducted. Quality assessment was performed using the NOS scale, and a meta-analysis was carried out with RevMan 5.4.1 software. Heterogeneity was assessed using the Q-test, and combined effects were calculated with fixed or random effects models. Results were visualized using forest plots, and a sensitivity analysis was performed. RESULTS: Out of 1,061 sources, 11 met the inclusion criteria. The meta-analysis indicated that the combination treatment significantly improved 1-year overall survival, objective response rate, and disease control rate compared to chemotherapy alone (P < 0.05), with no significant difference in adverse reactions (P > 0.05). Immune function markers CD4+ and CD4+/CD8+ were higher, and CD8+ was lower in the combined treatment group. Sensitivity analysis confirmed the stability and reliability of the results (OR (95% CI) 3.72 (2.34-5.90), P < 0.00001), although publication bias was indicated by funnel plots. CONCLUSION: The combination of chemotherapy and immunotherapy exhibits the potential to enhance both survival rates and clinical effectiveness, without the concomitant rise in severe adverse reactions.

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