Second-Line Immune Checkpoint Inhibitors in Patients with Advanced Esophagus Squamous Cell Cancer: A Multivariate Network Meta-Analysis of Survival Function Parameters

OBJECTIVES: Clinical evidence suggests that second-line immune checkpoint inhibitors (ICIs) can improve survival in patients with advanced esophagus squamous cell cancer (ESCC）. We aimed to compare the efficacy of different ICIs to determine the optimal treatment option using multivariate network meta-analysis(NMA) of survival function parameters.

METHODS: We performed a systematic review by retrieving up-to-date literature from PubMed, Embase, MEDLINE, ClinicalTrials.gov and major international conference publications. Relative treatment effects for overall survival (OS) and progression-free survival (PFS) were synthesized with a multivariate NMA of survival function parameters that allowed for hazard ratios (HRs) to vary over time.

RESULTS: Based on a deviance information criterion (DIC), the log-normal fixed-effects model displayed the best fit of data for both PFS and OS. Multivariate NMA results showed that patients on tislelizumab had a higher probability of longer PFS and OS than patients exposed to comparators.

CONCLUSIONS: This study found that tislelizumab was likely to be the best option in terms of OS and PFS in the second -line setting for patients with advanced ESCC.