Limitations
Only five RCTs and two RCTs referring to PD-1/PD-L1 antibodies combining
with other therapy we collected limited the analysis. All the RCTs were
open-label trials, which might influence compliance and detection bias.
We also included some single-arm trials, whereas some had small numbers
of participants, especially in the trials using combination therapy.
Publication bias of PFS, subgroups analyses of OS with clinical
characteristics (female, smoke current/former, never smoke, ECOG=0, and
ECOG≥1) some types of any grade AEs of PD-1/PD-L1 inhibitors (e.g.,
vomit, weight loss, dermatitis acneiform, leukopenia, neuropathy
peripheral and hypothyroidism), grade ≥3 AEs of PD-1/PD-L1 inhibitors
(e.g., neutrophil count decreased, decreased appetite, and leukopenia),
any grade AEs of PD-1 inhibitors (e.g., vomit, weight loss, alopecia,
neutropenia, nausea, and diarrhea), and grade ≥3 AEs of PD-1 inhibitors
(neutrophil count decreased) could not be detected because of the
limited number of available studies. However, the occurrence of any
grade hypothyroidism in PD-1/PD-L1 inhibitors was much higher than
standard of care, which could not be overlooked.