Evaluation of tumour vaccine immunotherapy for the treatment of advanced non-small cell lung cancer: a systematic meta-analysis.
Bottom Line: The results showed that the vaccine arm significantly extended primary endpoint median overall survival compared with control group (p<0.00001) (HR 0.760; 95% CI 0.644 to 0.896; p=0.001).Three subgroup patients with tumour vaccine at 1-year, 2-year and 3-year survival rates also gained significant benefits compared with their corresponding control group (p=0.0004, 0.03 and 0.19, respectively).A few severe adverse effects occurred in the tumour vaccine group, but fewer side effects were observed in the vaccine group compared with the control group (p<0.00001).
Affiliation: Biotherapy Center, General Hospital of Beijing Military Command, Beijing, People's Republic of China.Show MeSH
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Mentions: The analysis results of OS are shown in figure 2. Three OS subgroups of the tumour vaccine group at 1-year, 2-year and 3-year survival rate, gained significant benefits compared with their corresponding control group (OR 1.52, 95% CI 1.25 to 1.84, p=0.0004; OR 1.41,95% CI 1.12 to 1.77, p=0.03; OR 1.36,95% CI 1.05 to 1.77, p=0.19, respectively) (figure 2). Seven trials with 2286 patients were selected in 1-year OS analysis, in which 1332 patients received vaccine treatment, while the other 954 patients were in the control group.14151820–22 The 1-year OS rates were 70% (935/1332) for patients who received therapeutic tumour vaccines, however, the control group only showed 58% (555/954) of 1-year OS rate. Without obvious heterogeneity, I2 revealed minor heterogeneity among individual studies; the 1-year OS also produced significant improvement compared with control group (p=0.0004, I2=31%). The relevant data on 2-year OS were available in three trials.141517 A total of 1586 patients were included in 2-year OS analysis. The estimated pooled OR demonstrated that the vaccine group gained a significant improvement with 35% (355/1004) of 2-year survival rate versus 27% (157/582) for control group. There was moderate heterogeneity among individual studies on 2-year OS analysis (p=0.03, I2=48%). A total of two trials with 1410 patients was selected in 3-year OS analysis.1516 The 3-year survival rate for the 917 patients receiving vaccine treatment was 27% (247/917), whereas a slightly lower survival rate was found for control group with 22.3% (110/493). The high heterogeneity presented in 3-year OS rate, and statistic difference, was not observed in 3-year OS rate (p=0.19, I2=80%). A random effects model was used for OS in analysis of three subgroups. As for median OS, the results of the pooled analysis showed that the vaccine arm significantly extended median OS at the end of follow-up compared with the control group, which was consistent with the OS (OR 1.44,95% CI 1.27 to 1.64, p<0.00001) (figure 2 and table 3).14–1820212324
Affiliation: Biotherapy Center, General Hospital of Beijing Military Command, Beijing, People's Republic of China.