Association of Immune-Related Adverse Events and Efficacy in Advanced Non-Small-Cell Lung Cancer: A Systematic Review and Meta-Analysis

Aim: This study aimed to explore the association of immune-related adverse events (irAEs) with efficacy in advanced non-small-cell lung cancer (NSCLC). Materials & methods: A literature search was conducted under preselected criteria. Primary outcomes were hazard ratio (HR) and 95% CI of irAEs on objective response rate, overall survival (OS) and progression-free survival (PFS). Results: 35 studies covering 8435 patients with advanced NSCLC were included. Patients with irAEs exhibited significantly longer PFS and OS (for PFS, HR: 0.481; 95% CI: 0.370-0.568; p < 0.001 and for OS, HR: 0.470; 95% CI: 0.410-0.539; p < 0.001), and also showed significantly higher objective response rate compared with those without irAEs (pooled OR: 0.023 [95% CI: 0.009-0.590]). Conclusion: This meta-analysis showed that irAEs were associated with efficacy for advanced NSCLC.Immune-related adverse events (irAEs) are a series of adverse events that occur during the application of immune checkpoint inhibitors. The correlation between irAEs and ICI efficacy is controversial. In this meta-analysis, we analyzed the association of irAEs with the efficacy of immune checkpoint inhibitors in patients with advanced non-small-cell lung cancer (NSCLC). A total of 35 studies covering 8435 patients with NSCLC at advanced stage were included. Pooled analysis demonstrated that patients with irAEs got a significantly higher objective response rate than those without irAEs. Besides this, patients with irAEs had a more favorable survival outcome than those without. This study indicated that the occurrence of irAEs was associated with better survival outcome and higher tumor efficacy for patients with advanced NSCLC.