196
Volume 5, Issue 10: Special Issue
(EJAR)
ISSN: 2181-2020
MPHAPP
THE 6TH INTERNATIONAL SCIENTIFIC AND PRACTICAL
CONFERENCE
“
MODERN PHARMACEUTICS: ACTUAL
PROBLEMS AND PROSPECTS
”
TASHKENT, OCTOBER 17, 2025
in-academy.uz
SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EFFICACY AND SAFETY
OF TARGETED AND IMMUNOTARGETED AGENTS IN THE TREATMENT OF
NON-SMALL CELL LUNG CANCER
Rajabova N.Kh.
Tashkent Pharmaceutical Institute, Tashkent city, Republic of Uzbekistan
e-mail: nargiza-rh@mail.ru
https://doi.org/10.5281/zenodo.17332714
Relevance:
non-small cell lung cancer (NSCLC) remains one of the leading causes of cancer-
related morbidity and mortality worldwide. The introduction of targeted therapies (EGFR, ALK,
ROS1 inhibitors, etc.) and immune checkpoint inhibitors (PD-1/PD-L1) has markedly transformed
therapeutic strategies, shifting clinical practice toward a more personalized approach. Despite notable
advances, a systematic evaluation of accumulated data is required to determine the optimal
sequencing and combination of treatments, as well as to balance clinical efficacy with safety
outcomes.
Purpose of the study:
to conduct a systematic review and meta-analysis of clinical trials
comparing the efficacy and tolerability of targeted therapies and immunotherapeutic agents in
NSCLC.
Materials and methods:
a literature search was performed in PubMed, Embase, and the
Cochrane Library for the period 2015–2024. Eligible studies included randomized clinical trials and
meta-analyses reporting overall survival (OS), progression-free survival (PFS), objective response
rate (ORR), and adverse event profiles. Pooled estimates were calculated using a random-effects
model, and interstudy heterogeneity was assessed with the I² statistic.
Results:
а total of 36 studies, including over 14,000 patients, were analyzed. In patients with
driver mutations, targeted therapies significantly improved PFS (HR = 0.48; 95% CI: 0.41–0.56) and
increased ORR up to 65%, markedly outperforming chemotherapy. Immunotherapy with PD-1/PD-
L1 inhibitors demonstrated a clinically meaningful OS benefit in patients without EGFR/ALK
mutations and with high PD-L1 expression (≥50%) (HR = 0.74; 95% CI: 0.66–0.83). Safety analysis
revealed distinct toxicity profiles: targeted therapies were associated with dermatologic and
gastrointestinal adverse events, whereas immunotherapy was more frequently linked to immune-
related toxicities such as pneumonitis, thyroid dysfunction, and colitis.
Conclusions:
This meta-analysis supports the preferential use of targeted therapies in patients
with defined molecular alterations and highlights the efficacy of immunotherapy in cohorts with high
PD-L1 expression and no driver mutations. Optimal therapeutic strategies should be guided by
molecular profiling and biomarker assessment. Combination regimens involving targeted and
immunotherapeutic agents represent a promising direction, warranting further multicenter trials and
pharmacoeconomic evaluation within national healthcare systems.
