Adoptive Immunotherapy in Postoperative Non-Small-Cell Lung Cancer: A Systematic Review and Meta-Analysis.
BACKGROUND
Adoptive immunotherapy (AI) has been applied in the treatment of non-small-cell lung cancer (NSCLC) patients, but the value of postoperative AI has been inconclusive largely as a result of the small number of patients included in each study. We performed a systematic review and meta-analysis to address this issue for patients with postoperative NSCLC.


METHODS
Pubmed, Embase, Cochrane Library were searched for randomized controlled trials comparing adoptive immunotherapy with control therapies in postoperative NSCLC patients. The primary endpoint was overall survival. Hazard ratio (HR) was estimated and 95% confidence intervals (CI) were calculated using a fixed-effect model.


RESULTS
Compared with control therapies, analyses of 4 randomized controlled trials (472 patients) showed a significant benefit of adoptive immunotherapy on survival (hazard ratio [HR] 0.61, 95% CI 0.45-0.84, p = 0.002), and a 39% reduction in the relative risk of death (no evidence of a difference between trials; p = 0.16, I² = 42%). In subgroup analyses by treatment cycles and treatment regimen, significant OS benefit was found in combination therapy of AI with chemotherapy, regardless of whether or not the treatment cycles were more than 10 cycles.


CONCLUSIONS
Adoptive immunotherapy has the potential to improve overall survival in postoperative NSCLC. The findings suggest this is a valid treatment option for these patients. Further randomized clinical trials are urgently needed.
Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, No 151, Yanjiang Rd, Guangzhou, 510120, Guangdong Province, PR China.
Yuan
http://orcid.org/0000-0002-3270-2459
Y
Zeng
Guangzhou Zisheng Biotech Company Limited, No 11, Zhu Jiang East Rd, Guangzhou, 510120, Guangdong Province, PR China.
Wenli
W
Ruan
Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, No 151, Yanjiang Rd, Guangzhou, 510120, Guangdong Province, PR China.
Jiaxi
J
He
Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, No 151, Yanjiang Rd, Guangzhou, 510120, Guangdong Province, PR China.
Jianrong
J
Zhang
Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, No 151, Yanjiang Rd, Guangzhou, 510120, Guangdong Province, PR China.
Wenhua
W
Liang
Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, No 151, Yanjiang Rd, Guangzhou, 510120, Guangdong Province, PR China.
Yaoqi
Y
Chen
Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, No 151, Yanjiang Rd, Guangzhou, 510120, Guangdong Province, PR China.
Qihua
Q
He
Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, No 151, Yanjiang Rd, Guangzhou, 510120, Guangdong Province, PR China.
Jianxing
J
He
D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D016219:Immunotherapy, Adoptive; D008175:Lung Neoplasms / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D015996:Survival Rate