PD-1/PD-L1 inhibitors plus bevacizumab plus chemotherapy versus PD-1/PD-L1 inhibitors plus chemotherapy for advanced non-small cell lung cancer: a phase 3 RCT based meta-analysis

• DOI: 10.3389/fonc.2025.1496611
• Publication Date: 2025-05-21T05:26:27Z
• Authors: Chao Song; Yuan Qiu; Huan Fan; Yongqing Han

Background Combining PD-1/PD-L1 inhibitors with chemotherapy (PIC) is a standard first-line treatment for advanced non-small cell lung cancer (NSCLC). The addition of bevacizumab to this regimen (PD-1/PD-L1 inhibitors+bevacizumab+chemotherapy [PIBC]) remains controversial regarding its potential enhance antitumor efficacy in clinical practice. This meta-analysis aims compare the effectiveness and safety profiles PIBC PIC. Methods We systematically searched six databases identify eligible RCTs. primary outcomes were overall survival (OS) progression-free (PFS), while secondary included responses adverse events (AEs). Results Three RCTs (IMpower150, jRCT2080224500, ORIENT-31) comprising total 1529 patients analyzed. significantly improved PFS (hazard ratio [HR]: 0.76 [0.66, 0.87], P < 0.0001), objective response rate (risk [RR]: 1.36 [1.22, 1.51], 0.00001), disease control (RR: 1.06 [1.00, 1.12], = 0.04). rates also higher group at 6 18 months. Both groups showed similar results terms OS, 3–36 month OS rates, AEs. However, exhibited incidence grade 3–5 AEs, serious treatment-related AEs (TRAEs) TRAEs. most frequent anorexia (36.40%), decreased neutrophil count (16.25%), neutropenia (13.50%), reduced white blood (12.12%), febrile (9.42%). Conclusions appears be better than PIC NSCLC offering (ORR DCR). requires cautious attention. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42024559146 , identifier CRD42024559146.