AI Article Synopsis
- PD-1/PD-L1 inhibitors (PIs) show promise in the treatment of resectable non-small cell lung cancer (NSCLC), but more large-scale evidence is needed for their effectiveness in perioperative settings.
- * A meta-analysis of six randomized controlled trials (RCTs) involving 2,941 patients found that integrating perioperative PIs with neoadjuvant chemotherapy significantly improved overall survival and event-free survival, as well as pathological responses.
- * Despite these benefits, the combination treatment also led to a higher incidence of serious adverse events, indicating the need for careful evaluation of the risks associated with this approach.
Article Abstract
Background: PD-1/PD-L1 inhibitors (PI) have shown promising results in both neoadjuvant and adjuvant therapies for resectable non-small cell lung cancer (NSCLC). However, substantial evidence from large-scale studies is still lacking for their use in the perioperative setting (neoadjuvant plus adjuvant). This meta-analysis aims to evaluate the integration of perioperative PI (PPI) with neoadjuvant chemotherapy for resectable NSCLC.
Methods: To identify appropriate randomized controlled trials (RCTs), we thoroughly explored six different databases. The primary endpoint was survival, while the secondary measures included pathological responses and adverse events (AEs).
Results: Six RCTs involving 2941 patients were included. The PPI group significantly improved overall survival (OS) (hazard ratio [HR]: 0.62 [0.51, 0.77]), event-free survival (EFS) (HR: 0.57 [0.51, 0.64]), pathological complete response (risk ratio [RR]: 5.81 [4.47, 7.57]), and major pathological response (RR: 2.60 [1.77, 3.82]). Benefits in EFS were seen across all subgroups. OS rates at 12-48 months and EFS rates at 6-48 months were higher in the PPI cohort. Furthermore, the advantages in OS and EFS increased with prolonged survival times. The PPI group also exhibited higher rates of surgery and R0 resections. However, the PPI group experienced more grade 3-5 AEs, serious AEs, and treatment discontinuations due to AEs.
Conclusions: The integration of perioperative PI with neoadjuvant chemotherapy can significantly improve survival and pathological responses for resectable NSCLC. However, the increased incidence of grade 3-5 AEs must be carefully evaluated.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11419369 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0310808 | PLOS |
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