Table 2.
Results and quality assessment of meta-analyses for vaccine therapy after first-line therapy.
| Outcomes | Indicator | Sample and study | Effect (95% CI) | GRADE quality assessment |
GRADE quality | AMSTAR 2 rating | Figure | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Limitation | Indirectness | Inconsistency | Imprecision | Publication bias | Large effect | Dose response | Plausible confounding | |||||||
| Meta-analysis of clinical outcomes | ||||||||||||||
| Survival | OS | 320115, 16, 17,19, 20, 21, 22, 23, 24, 25 | 0.85 (0.78–0.92) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | 2A |
| PFS | 93015,19,21,24 | 0.91 (0.79–1.05) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | 2B | |
| Meta-analysis of safety outcomes | ||||||||||||||
| Safety | AEs | 222815,18,21,23 | 1.66 (0.91–3.00) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | S5A |
| SAEs | 222815,18,21,23 | 1.03 (0.73–1.45) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | S5B | |
| TRAEs | 244015,16,18,21,23 | 1.50 (0.63–3.61) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | S5C | |
| TRSAEs | 244015,16,18,21,23 | 1.09 (0.38–3.11) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | S5D | |
| Subgroup meta-analysis of OS | ||||||||||||||
| ECOG PS | ECOG = 0 | 60315,16,19,21,23 | 0.73 (0.53–1.00) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | 3A |
| ECOG = 1 | 60315,16,19,21,23 | 0.80 (0.68–0.95) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | ||
| ECOG = 2 | 4219,23 | 1.24 (0.54–2.85) | Not serious | Not serious | Not serious | Not serious | Suspected | No | No | No | ⊕⊕⊕○ (Moderate) | High | ||
| Tumor stage | IIIA | 58918,19,21 | 0.91 (0.72–1.15) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | 3B |
| IIIB | 136015,18,19,21,23 | 0.80 (0.62–1.04) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | ||
| IV | 76815,16,19,23 | 0.83 (0.70–0.98) | Not serious | Not serious | Not serious | Not serious | Suspected | No | No | No | ⊕⊕⊕○ (Moderate) | High | ||
| First-line therapy | Chemo | 81815,20,23,25 | 0.78 (0.66–0.93) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | 3C |
| Chemoradio | 157219,21,22 | 0.85 (0.71–1.03) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | ||
| First-line response | SD | 73715,16,18,21,23 | 0.78 (0.67–0.92) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | 3D |
| OR | 113415,16,18,21 | 0.73 (0.49–1.07) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | ||
| Histology | Adeno | 60315,19,21,23 | 0.83 (0.55–1.26) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | 3E |
| Squamous | 48415,16,19,23 | 0.74 (0.61–0.90) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | ||
| Smoking | Never | 9016,21,23 | 0.91 (0.56–1.49) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | 3F |
| Former | 43315,16,23 | 0.73 (0.56–0.97) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | ||
| Current | 19315,16,23 | 0.61 (0.46–0.81) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | ||
| Age | <65 years | 74016,19,21,23 | 0.86 (0.71–1.04) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | 3G |
| ≥65 years | 48816,19,21,23 | 0.86 (0.69–1.08) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | ||
| Vaccine | L-BLP25 | 158217,21,22 | 0.87 (0.77–0.99) | Not serious | Not serious | Not serious | Not serious | Undetected | No | No | No | ⊕⊕⊕⊕ (High) | High | 3H |
| Exploratory meta-analysis of correction between immune response and OS | ||||||||||||||
| OS | Immune response | 16315,20,24,25 | 0.34 (0.24–0.50) | Not serious | Not serious | Not serious | Not serious | Undetected | Yes | No | No | ⊕⊕⊕⊕ (High) | High | 4A |
OS: Overall survival, PFS: Progression-free survival, AEs: Adverse events, SAEs: Serious adverse events, TRAEs: Treatment-related adverse events, TRSAEs: Treatment-related serious adverse events, ECOG PS: Eastern Cooperative Oncology Group Performance Status, Chemo: Chemotherapy, Chemoradio: Chemoradiotherapy, SD: Stable disease, OR: Objective response, Adeno: Adenocarcinoma, Squamous: Squamous cell carcinoma.