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PD-1 inhibitor plus chemotherapy improves progression-free survival and overall survival in driver gene-negative NSCLCAdding PD-1 inhibitors to chemotherapy improves lung cancer survival

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Key Takeaway
Consider PD-1 inhibitor plus chemotherapy as a superior strategy for progression-free survival in driver gene-negative NSCLC.

This network meta-analysis evaluated treatment options for patients with driver gene-negative non-small cell lung cancer (NSCLC) and liver metastases, incorporating data from 20 randomized controlled trials. The study compared PD-1 inhibitor plus chemotherapy against chemotherapy alone as the primary comparator.

The analysis indicates that adding a PD-1 inhibitor to chemotherapy significantly improves progression-free survival (PFS) with an HR of 0.572 (95% CI: 0.435 to 0.754). Additionally, this combination significantly improved overall survival (OS) with an HR of 0.681 (95% CI: 0.559 to 0.830). In the specific subset of squamous NSCLC, the addition of a PD-1 inhibitor showed a PFS advantage (HR = 0.583; 95% CI: 0.386 to 0.882).

Camrelizumab plus chemotherapy was ranked highest for both PFS and OS based on SUCRA values of 84.18% and 96.38%, respectively. However, the authors note that because these results are derived from a network meta-analysis involving indirect comparisons, they should be interpreted with caution. The study identifies PD-1 inhibitor plus chemotherapy as a potentially superior strategy for this specific patient population.

How this fits prior evidence

This finding extends prior evidence regarding immune checkpoint inhibitors in advanced non-small cell lung cancer. Specifically, it builds upon the established superiority of PD-1 inhibitors combined with chemotherapy over PD-L1 inhibitors plus chemotherapy. While previous data confirmed the efficacy of these combinations, this meta-analysis specifically addresses the subset of patients with driver gene-negative NSCLC and liver metastases, identifying a favorable ranking for Camrelizumab plus chemotherapy.

Living with lung cancer that has spread to the liver is incredibly difficult. For patients with a specific type of lung cancer called driver gene-negative NSCLC, finding the right treatment path is vital. New data suggests that adding a PD-1 inhibitor—a type of immunotherapy—to standard chemotherapy can significantly improve outcomes compared to using chemotherapy alone.

The analysis looked at 20 different trials involving patients with this specific condition. The results showed that those who received both the immunotherapy and chemotherapy had better progression-free survival and overall survival rates. Specifically, a combination including Camrelizumab was ranked highly in these comparisons for both staying stable and extending life.

While these results are promising, it is important to remember that some of these findings come from indirect comparisons between different treatments. Because the data comes from a network analysis rather than direct head-to-head trials for every drug, doctors should view these results as a helpful guide rather than a definitive rule. Talk with your medical team to see if this combination is right for your specific situation.

What this means for you:
Adding a PD-1 inhibitor to chemotherapy can improve survival for certain types of lung cancer with liver spread.

Common questions

How does adding a PD-1 inhibitor change treatment for lung cancer?

Adding a PD-1 inhibitor to standard chemotherapy significantly improved progression-free survival and overall survival compared to using chemotherapy alone. This combination was found to be more effective at keeping the cancer from growing or spreading for patients with driver gene-negative NSCLC and liver metastases.

Is Camrelizumab a good option for this type of lung cancer?

In the study, Camrelizumab plus chemotherapy ranked highest for both progression-free survival and overall survival. However, because these results involved some indirect comparisons, doctors suggest interpreting these specific rankings with caution when making treatment decisions.

Who specifically does this finding help?

These findings specifically involve patients with driver gene-negative non-small cell lung cancer (NSCLC) that has spread to the liver. The data also showed a survival advantage for those with squamous NSCLC when using the combination of a PD-1 inhibitor and chemotherapy.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJul 2026
View Original Abstract ↓
This study aimed to evaluate the first-line treatment patterns and prognostic factors associated with survival in patients with driver gene-negative non-small cell lung cancer (NSCLC) and liver metastases, in order to identify the optimal treatment strategy. A Bayesian network meta-analysis was performed using R software (version 4.2.3) and RevMan (version 5.4) to systematically compare the efficacy of various first-line treatment regimens, including chemotherapy, immunotherapy, and combination therapy, in patients with driver gene-negative NSCLC with liver metastases. A total of 20 randomized controlled trials were included. Among patients with driver gene-negative NSCLC and liver metastases: (1) PD-1 inhibitor plus chemotherapy significantly improved progression-free survival (PFS) (HR = 0.572, 95% CI: 0.435–0.754) and overall survival (OS) (HR = 0.681, 95% CI: 0.559–0.830) compared with chemotherapy alone. (2) In the patients with non-squamous NSCLC, PD-1/PD-L1 inhibitor plus chemotherapy resulted in a greater PFS benefit than chemotherapy alone. (3) A similar PFS advantage was observed in patients with squamous NSCLC receiving PD-1 inhibitor plus chemotherapy versus chemotherapy alone (HR = 0.583, 95% CI: 0.386–0.882). (4) Camrelizumab plus chemotherapy (CAM+CT) ranked highest in the network meta-analysis, with the top SUCRA values for both PFS (84.18%) and OS (96.38%). In treatment-naive driver gene-negative NSCLC with liver metastases: PD-1 inhibitor plus chemotherapy conferred more significant PFS and OS benefits than chemotherapy alone. CAM+CT appeared to rank favorably among the evaluated regimens, particularly in patients with squamous NSCLC and liver metastases, suggesting it may represent a candidate treatment strategy. However, given that these findings were derived from a network meta-analysis based on indirect comparisons, they should be interpreted with caution. https://www.crd.york.ac.uk/PROSPERO/view/CRD42025632364, identifier CRD42025632364.
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