Efficacy of pd-l1 inhibitors in non-small cell lung cancer: a systematic review

Keywords

non-small cell lung cancer - PD-L1 Inhibitors - immune checkpoint - efficacy

Introduction: Representing 80% of all lung cancers, non-small cell lung cancer (NSCLC) is one of the leading causes of cancer-related death and encompasses adenocarcinoma and squamous cell carcinoma. Studies indicate that the use of inhibitors of programmed cell death protein 1 (PD-1) and programmed cell death ligand 1 (PD-L1), which are common biomarkers in patients with NSCLC, may be effective in enhancing therapy for various diseases, including NSCLC. By inhibiting the PD-1/PD-L1 binding complex, patients may achieve improved survival.

Objectives: To evaluate the efficacy of PD-L1 inhibitors in the treatment of non-small cell lung cancer and compare the efficacy of PD-L1 inhibitors with other immunotherapies.

Methodology: A systematic review was conducted using PubMed with the descriptors “immune checkpoint inhibitors,” “PD-L1 inhibitors,” and “carcinoma, non-small-cell lung,” combined with Boolean operators AND and OR. Studies in English published between 2019 and 2024 were included. Articles on other checkpoint inhibitors were excluded. Out of 153 articles identified, 16 were selected.

Results: Analysis of the studies showed that PD-L1 inhibitor monotherapy significantly improved Overall Survival (OS) as well as Progression-Free Survival (PFS). When used in combination with chemotherapy, there were significant improvements in OS, PFS, Objective Response Rate (ORR), Event-Free Survival (EFS), and PFS. However, there were many grades 3-5 adverse effects both in monotherapy and when combined with chemotherapy, leading to treatment discontinuation. Other therapies, such as PD-1 inhibitors, were associated with better OS, PFS, and safety, as well as lower mortality rates compared to PD-L1 inhibitors, with reduced adverse effects and treatment discontinuation. Comparison of CTLA-4 inhibitors with PD-L1 and PD-1 inhibitors did not yield significant results but suggested that PD-1 and PD-L1 inhibitors have better efficacy.

Conclusion: There is a consistent relationship between PD-1 and PD-L1 inhibitors and significant improvements in survival-related outcomes, including reduced risk of death and adverse events, with PD-1 inhibitors showing superior results in terms of lower mortality and minimized treatment discontinuation.

Corresponding author: Layaly Ayoub Silva (e-mail: [e-mail]).

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
06 May 2025