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However, disproportionate enrollment among races and ethnicities places the generalizability of global trial results in doubt.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this systematic review, phase 3 randomized controlled trials investigating pembrolizumab in advanced cancers and providing subgroup analyses of Asian and non\u2010Asian participants were included. The primary and secondary effect measures were the mean differences (MDs) in the natural logarithms of the hazard ratios (HRs) for overall survival (OS) and progression\u2010free survival (PFS) between these two subgroups, respectively. We used random\u2010effects meta\u2010analysis to calculate the pooled ratios of HRs (i.e., exp(MD)) and implemented a meta\u2010regression analysis to identify significant covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 17 and 11 trials were included in the meta\u2010analyses of OS and PFS, respectively. These trials included 2732 (25.49%) Asian and 7000 (65.32%) non\u2010Asian participants in the OS analysis and 1438 (22.5%) Asian and 4129 (64.61%) non\u2010Asian participants in the PFS analysis. The pooled ratio of HRs for OS was 0.87 (95% CI: 0.76\u20130.99; <jats:italic>p<\/jats:italic>\u2009=\u20090.0391), favoring Asian participants, but no significant difference was found in PFS (pooled ratio of HRs: 0.93; 95% CI: 0.82\u20131.07; <jats:italic>p<\/jats:italic>\u2009=\u20090.2391). Both linear meta\u2010regression analyses revealed an open\u2010label design as a crucial covariate, which indicated more benefits for non\u2010Asian participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared with non\u2010Asian patients, Asian patients with advanced cancers may derive superior OS benefits from pembrolizumab. Although the results warrant further exploration, this meta\u2010analysis provides insight into clinical research design.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.6563","type":"journal-article","created":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T10:13:17Z","timestamp":1695377597000},"page":"20035-20051","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Disparity in survival benefits of pembrolizumab between Asian and <scp>non\u2010Asian<\/scp> patients with advanced cancers: A systematic review and <scp>meta\u2010regression<\/scp> analysis"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5260-9585","authenticated-orcid":false,"given":"Shang\u2010Hsuan","family":"Peng","sequence":"first","affiliation":[{"name":"Department of Oncology National Taiwan University Hospital Yunlin Branch  Yunlin 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