Efficacy and safety of nivolumab and docetaxel combination therapy versus nivolumab monotherapy for the treatment of advanced non-small cell lung cancer: A systematic review and meta-analysis.

Abstract

e20619 Background: Nivolumab has demonstrated efficacy over chemotherapy for the management of advanced non-small cell lung cancer (NSLC). Recent evidence suggests that combining nivolumab with docetaxel may enhance outcomes compared to nivolumab monotherapy. Therefore, we conducted this meta-analysis to evaluate the efficacy and safety of nivolumab and docetaxel combination therapy versus nivolumab monotherapy in the treatment of advanced NSLC. Methods: PubMed, Cochrane and Embase databases were searched to identify relevant studies. The primary endpoints included overall survival (OS) and progression free survival (PFS). Grade 3-5 adverse events, objective response rate (ORR) and disease control rate (DCR) comprised the secondary endpoints. Results: A total of three studies including 227 patients were included in the analysis. Combination therapy was associated with a significantly increased OS (Pooled RR: 1.66, 95% CI: 1.23 to 2.25, P=0.001, I2=0%), PFS (Pooled RR: 2.36, 95% CI: 1.54 to 3.61, P<0.0001, I 2 =0%) and DCR (MD: 39.88, 95% CI: 29.22 to 50.53, P<0.00001, I 2 =0%). The incidence of grade 3-5 adverse events was higher in the combination arm (Pooled RR: 5.38, 95% CI: 1.60 to 18.11, P=0.007, I 2 =0%), however treatment discontinuations (Pooled RR: 1.84, 95% CI: 0.62 to 5.40, P=0.27, I 2 =0%) due to adverse events did not significantly differ between the two groups. Conclusions: Nivolumab and Docetaxel combination therapy demonstrates greater efficacy compared to monotherapy for the management of advanced NSLC. However, careful patient selection and monitoring is imperative to minimize adverse events. Further, well designed trials and real-world studies are needed to confirm these findings and guide patient management.