Indirect comparison between immunotherapy alone and immunotherapy plus chemotherapy as first-line treatment for advanced non-small cell lung cancer: A systematic review

Objectives: Use of immune checkpoint inhibitors (ICIs) as first-line treatment for advanced (stage IIIB/IV) non-small cell lung cancer (NSCLC) remains controversial. Clinical trials comparing single-drug immunotherapy (IO) with immunotherapy plus chemotherapy (IC) are lacking. We aimed to compare the efficacy of IO alone with that of IC as first-line treatment for advanced NSCLC.

Design: Systematic review

Data sources: PubMed, the Cochrane Library, and Embase for related studies on NSCLC; ClinicalTrials.gov, American Society of Clinical Oncology Meeting Library, and World Conference on Lung Cancer for relevant conference abstracts.

Eligibility criteria: Articles meeting the following criteria were selected: (1) randomized controlled trials on NSCLC treatment, (2) all individuals in the studies had not received treatment previously, and (3) research on IO monotherapy using programmed death-1/programmed death ligand-1 (PD-L1) inhibitors or IC.

Data extraction and synthesis: Af...