Estimating and Interpreting the Overall Survival Benefit of Checkpoint Inhibitors via Meta-analysis

To the Editor Lee et al conducted an interesting meta-analysis to estimate the relative efficacy of checkpoint inhibitor vs docetaxel for treatment of advanced non–small cell lung carcinoma. The meta-analysis consists of 5 comparative clinical trials (CheckMate-017, CheckMate-057, Keynote-010, OAK, POPLAR) with the overall survival (OS) end point. For each study, the hazard ratio (HR) was used to quantify the treatment effect. A weighted average of 5 HRs was constructed as the pooled treatment effect from checkpoint inhibitors using the fixed-effects inverse-variance-weighted method. This resulted in a combined HR (checkpoint inhibitor vs docetaxel) of 0.69 (95% CI, 0.63-0.75).

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