Trial-specific absolute disease-free survival effects of postoperative PD-1/PD-L1 blockade after complete resection of NSCLC: A systematic review.
Zhiheng Yao, Xinyuan Wang, Hanliang Zhang et al.
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In 30 seconds
This systematic review estimated absolute disease-free survival (DFS) effects of postoperative single-agent PD-1/PD-L1 blockade after complete resection of non-small-cell lung cancer. It included four randomized phase III trial families with 4,336 participants and reconstructed published Kaplan–Meier curves. At 36 months, estimated restricted mean DFS time differences ranged from 1.34 to 1.97 months, while DFS probability differences represented 2.3–6.1 additional participants without a trial-defined DFS event per 100 randomized. Estimates were uncertain: confidence intervals included zero for two restricted mean and three DFS probability estimates.
Key findings
- Across four trial families and 4,336 participants, 36-month restricted mean DFS differences ranged from 1.34 to 1.97 months.
- DFS probability differences corresponded to 2.3–6.1 additional participants without a trial-defined DFS event per 100 randomized.
- Confidence intervals included zero for two restricted mean DFS and three DFS probability estimates.
- In three trials with available between-arm safety data, severe and serious adverse events were more frequent with checkpoint blockade.
Why it matters
Relative treatment effects can be difficult to translate into expected benefit after surgery. These trial-specific absolute estimates provide a complementary way to describe DFS outcomes, while their uncertainty cautions against assuming a consistent class-wide effect or predicting benefit for an individual. The reported safety findings also matter when weighing postoperative treatment effects.
What to keep in mind
Absolute effects were reconstructed from published Kaplan–Meier curves, and estimates were uncertain. Safety data were available for only three trials; overall survival analyses were exploratory.