Main Session
Sep 29
PQA 07 - Head and Neck Cancer, Lung Cancer/Thoracic Malignancies, and Nursing and Supportive Care

3543 - Efficacy and Safety of PD-L1 Versus PD-1 Inhibitors as Consolidation Therapy Following Concurrent Chemoradiotherapy for Unresectable Stage III Non-Small Cell Lung Cancer: A Real-World Retrospective Study

03:45pm - 05:00pm ET
Poster Hall - Exhibit Hall A
Screen: 23
POSTER

Presenter(s)

Xiaoli Liu, MBBS - Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong

X. Liu1,2, Y. Qin1, Y. Lin3, P. Li1, Y. Wang4, J. Yuan4, B. Tian1, F. Wang4, Y. Xu4, A. Jiang4, and D. Chen4; 1Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China, 2Shandong Second Medical University, weifang, China, 3School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China, 4Shandong Provincial Key Laboratory of Precision Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China

Purpose/Objective(s):

The PACIFIC trial established consolidation immune checkpoint inhibitors (ICIs) following concurrent chemoradiotherapy (cCRT) as standard care for unresectable stage III non-small cell lung cancer (NSCLC). Both programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) inhibitors are used, but their comparative effectiveness and safety remain uncertain. This study aims to compare the efficacy and safety of these two immunotherapy drugs.

Materials/Methods:

This study combines meta-analysis with a real-world retrospective study. The meta-analysis followed the PRISMA 2020 and MOOSE guidelines, was registered on PROSPERO (CRD420251102812), and searched the PubMed, Embase, and Web of Science databases to extract data related to PD-1/PD-L1 treatment in patients with stage ? NSCLC. A random-effects model analysis was performed using the "meta" package in R software, and the corresponding tools were used to assess the quality of the studies. The real-world study was a single-center retrospective cohort study that included 181 patients with unresectable stage ? NSCLC who received cCRT combined with immune consolidation therapy from 2019 to 2024. Clinical data were extracted from the institutional electronic medical records and oncology information systems, and statistical analyses were conducted using the Kaplan-Meier method, log-rank test, and Cox regression analysis, with SPSS 27.0 and R 4.4.3 software used for implementation.

Results:

Fourteen studies with 3418 participants were included in the survival meta-analysis. Pooled analysis indicated that PD-L1 consolidation was associated with higher 6-, 12-, 18-, and 24-month OS rates than PD-1 and with significantly better 6- and 12-month PFS. In the real-world cohort, PD-L1 consolidation improved PFS versus PD-1 (hazard ratio [HR] 0.609; 95% confidence interval [CI] 0.396–0.937; P = 0.024), with a non-significant trend toward longer OS (HR 0.604; 95% CI 0.326–1.121; P = 0.110). There was no statistically significant difference in the incidence of treatment-related pneumonia between the two groups.

Conclusion:

Among patients with unresectable stage III NSCLC treated with cCRT, consolidation PD-L1 inhibitors were associated with superior PFS and higher short-term OS rates versus PD-1 inhibitors, without increased pneumonitis. These findings support preferential use of PD-L1 agents in this setting and this study serve as a reference for the selection of immunotherapeutic agents in patients with unresectable stage III NSCLC.