Efficacy of first-line treatment in driver gene-negative non-small cell lung cancer with liver metastases: a Bayesian network meta-analysis
In brief
PD-1 inhibitor plus chemo cuts progression risk by 43% in NSCLC liver metastases
A network meta-analysis of 20 trials found that adding a PD-1 blocker to chemotherapy improved progression-free survival by about 43% and overall survival by roughly 32% compared with chemotherapy alone in driver-gene-negative NSCLC with liver spread. Camrelizumab plus chemotherapy ranked highest for both outcomes, but the evidence is indirect and should be interpreted cautiously.
- Journal
- Frontiers in immunology (Q1)
- Published
- 15 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Weiqian Wu, Xiaoyu Guo, Xueqi Dong, Hongyuan Liang, Lingyun Zhang
- PMID
- 42529281
- DOI
- 10.3389/fimmu.2026.1791664
Why clinicians should know about it
- Picked for Radiology, Radiation Oncology, Nuclear Medicine, Medical Physics and Imaging (top studies of the week, 2 August 2026): Not directly related to radiology or nuclear imaging
- Picked for Pharmacology (medical) (top studies of the week, 2 August 2026).
- Picked for Pulmonary and Respiratory Medicine (top studies of the week, 2 August 2026).
- Picked for Public Health, Environmental and Occupational Health (top studies of the week, 2 August 2026).
Abstract
OBJECTIVE: 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. METHODS: 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. RESULTS: 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%). CONCLUSION: 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. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD42025632364, identifier CRD42025632364.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.