Efficacy of cancer immunotherapy: An umbrella review of meta-analyses of randomized controlled trials

Jong Yeob Kim, Keum Hwa Lee, Michael Eisenhut, Hans J. van der Vliet, Andreas Kronbichler, Gwang Hun Jeong, Jae Il Shin, Gabriele Gamerith

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Abstract

We conducted a systematic review for evidence of the clinical efficacy of cancer immunotherapies. We searched PubMed from inception to 14 February 2018 for meta-analyses of randomized controlled trials (RCTs) of cancer immunotherapies. Re-analyses were performed to estimate the summary effect size under random-effects, the 95% confidence interval (CI), heterogeneity, and the 95% prediction interval, and we determined the strength of the evidence. We examined publication bias and excess significance bias. 63 articles corresponding to 247 meta-analyses were eligible. Nine meta-analyses were classified to have convincing evidence, and 75 were classified as suggestive evidence. The clinical benefit of immunotherapy was supported by convincing evidence in the following settings: anti-PD-1/PD-L1 monoclonal antibody (mAb) therapy for treating advanced melanoma and non-small cell lung cancer (NSCLC), the combination of rituximab and chemotherapy for treating chronic lymphocytic leukemia and B-cell non-Hodgkin’s lymphoma, adoptive cell immunotherapy for NSCLC, and the combination of interferon α and chemotherapy for metastatic melanoma. A further meta-analysis of 16 RCTs showed that anti-PD-1/PD-L1 mAb therapy had a benefit in patients with solid tumors (overall survival; hazard ratio = 0.73, 95% CI: 0.68–0.79; p < 0.001), supported by convincing evidence. In the future, rigorous approaches are needed when interpreting meta-analyses to gain better insight into the true efficacy of cancer immunotherapy.
Original languageEnglish
Article number1801
JournalCancers
Volume11
Issue number11
DOIs
Publication statusPublished - 2019

Cite this

Kim, J. Y., Lee, K. H., Eisenhut, M., van der Vliet, H. J., Kronbichler, A., Jeong, G. H., ... Gamerith, G. (2019). Efficacy of cancer immunotherapy: An umbrella review of meta-analyses of randomized controlled trials. Cancers, 11(11), [1801]. https://doi.org/10.3390/cancers11111801