2025 Volume 65 Issue 6 Pages 901-910
Objective. Although the treatment of non-small cell lung cancer has advanced with the use of immune checkpoint inhibitors (ICIs), clear guidelines for administration are lacking. This study aimed to identify patients who could benefit from platinum-doublet chemotherapy (PDC) and ICI combination therapy. Methods. A meta-analysis of clinical trials referenced in the "Guidelines for Diagnosis and Treatment of Lung Cancer 2024" was performed. Results. When comparing PDC+ICI and PDC alone, the overall survival analysis yielded an integrated hazard ratio of 0.73 (95% confidence interval [CI]: 0.66-0.81), indicating that adding ICI agents significantly improves survival outcomes. A subgroup analysis based on age and the programmed cell death ligand 1 (PD-L1) expression showed no significant differences. However, the incidence of adverse events was significantly increased, with a risk ratio of 1.10 (95% CI: 1.02-1.18). Furthermore, the risk ratio for febrile neutropenia was 1.53 (95% CI: 1.13-2.06), indicating a significant increase. Conclusion. PDC+ICI was beneficial regardless of age and PD-L1 expression level. Additionally, it was suggested that PDC+ICI may increase the risk of febrile neutropenia.
