WCLC 2025 - Posters & ePosters-P2.10.08 Antibody-Drug Conjugates Versus Docetaxel for Previously Treated Advanced NSCLC: Systematic Review and Meta-Analysis of RCTs

P2.10.08 Antibody-Drug Conjugates Versus Docetaxel for Previously Treated Advanced NSCLC: Systematic Review and Meta-Analysis of RCTs

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This systematic review and meta-analysis evaluated the efficacy and safety of Antibody Drug Conjugates (ADCs) compared to docetaxel in patients with previously treated advanced non-small cell lung cancer (NSCLC). Docetaxel, following progression after immunotherapy and platinum-based chemotherapy, is the current standard but has limited effectiveness. ADCs combine a monoclonal antibody targeting tumor-associated antigens with a cytotoxic agent, potentially improving outcomes.<br /><br />The study followed PRISMA guidelines and included three randomized controlled trials with a total of 1597 patients, identified through extensive literature and registry searches up to November 2024. The primary endpoints were progression-free survival (PFS) and overall survival (OS), while secondary endpoints included objective response rate (ORR), disease control rate (DCR), and adverse events (AEs).<br /><br />Meta-analysis showed no significant PFS improvement with ADCs compared to docetaxel (pooled HR 0.91, 95% CI 0.73-1.13). OS analysis revealed a borderline significant trend favoring ADCs overall (HR 0.88, 95% CI 0.78-1.00, p=0.06), with a significant OS benefit in the non-squamous NSCLC subgroup (HR 0.85, 95% CI 0.74-0.98, p=0.03). No significant differences were found in ORR and DCR between the treatments.<br /><br />Regarding safety, there was no significant difference in any-grade treatment-related adverse events between ADCs and docetaxel. Importantly, grade 3 or higher adverse events were significantly less frequent with ADCs (OR 0.49, 95% CI 0.26-0.90, p=0.02), although heterogeneity was high.<br /><br />In conclusion, while overall efficacy was comparable between ADCs and docetaxel, ADCs provided a survival advantage in non-squamous NSCLC patients with a favorable safety profile. Limitations include the small number of trials, inter-study heterogeneity, and variable biomarker expression. Further research should focus on patient selection, biomarker-driven approaches, and longer follow-up to clarify ADCs’ role in this setting.

Asset Subtitle

Saqib Khan

Meta Tag

Speaker Saqib Khan

Topic Metastatic Non-small Cell Lung Cancer – Cytotoxic Therapy

Keywords

Antibody Drug Conjugates

ADCs

docetaxel

non-small cell lung cancer

NSCLC

progression-free survival

overall survival

randomized controlled trials

treatment-related adverse events

non-squamous NSCLC