Efficacy of Immune Checkpoint Inhibitors against Advanced or Metastatic Neuroendocrine Neoplasms: A Systematic Review and Meta-Analysis

Eun Joo Park, Hyo Jung Park*, Kyung Won Kim, Chong Hyun Suh, Changhoon Yoo, Young Kwang Chae, Sree Harsha Tirumani, Nikhil H. Ramaiya

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

We performed a systematic review and meta-analysis of the treatment efficacy of immune checkpoint inhibitors (ICIs) in advanced/metastatic neuroendocrine neoplasms (NENs). MEDLINE and EMBASE were searched to identify studies that provide data on treatment response and/or survival outcomes of advanced/metastatic NEN patients treated with ICIs. The overall response rate (ORR) was pooled using a random-effects model. Meta-regression was performed to explore factors influencing the ORR. Individual patient data (IPD) meta-analysis of survival was performed using stratified Cox regression. Ten studies (464 patients) were included. The overall pooled ORR was 15.5% (95% confidence interval (CI), 9.5–24.3%), and it varied according to the primary site (thoracic, 24.7%; gastro–entero–pancreatic, 9.5%), tumor differentiation (poorly differentiated, 22.7%; welldifferentiated, 10.4%), and drug regimen (combination, 25.3%; monotherapy, 10.1%). All these variables significantly influenced the ORR. Tumor differentiation was associated with both overall survival and progression-free survival (hazard ratio of poorly differentiated tumors, 4.2 (95% CI, 2.0– 8.7) and 2.6 (95% CI, 1.6–4.4), respectively). Thus, the treatment efficacy of ICIs for advanced/meta-static NENs varied according to primary site, tumor differentiation, and drug regimen. Poorly differentiated NENs showed a better ORR than well-differentiated NENs but had a negative impact on survival.

Original languageEnglish (US)
Article number794
JournalCancers
Volume14
Issue number3
DOIs
StatePublished - Feb 1 2022

Keywords

  • Checkpoint inhibitors
  • Immunotherapy
  • Neuroendocrine neoplasm
  • Treatment efficacy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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