PD-1/PD-L1 Inhibitors plus Chemotherapy Versus Chemotherapy Alone for Resectable Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Background: The benefit of adding programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors to the treatment of early-stage non-small cell lung cancer (NSCLC), both neoadjuvant therapy (NAT) and adjuvant therapy (AT), is not yet fully elucidated. Methods: We searched PubMed...
Gespeichert in:
Veröffentlicht in: | Cancers 2023-11, Vol.15 (21), p.5143 |
---|---|
Hauptverfasser: | , , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | |
---|---|
container_issue | 21 |
container_start_page | 5143 |
container_title | Cancers |
container_volume | 15 |
creator | Pasqualotto, Eric Moraes, Francisco Cezar Aquino de Chavez, Matheus Pedrotti Souza, Maria Eduarda Cavalcanti Rodrigues, Anna Luíza Soares de Oliveira Ferreira, Rafael Oliva Morgado Lopes, Lucca Moreira Almeida, Artur Menegaz de Fernandes, Marianne Rodrigues Santos, Ney Pereira Carneiro dos |
description | Background: The benefit of adding programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors to the treatment of early-stage non-small cell lung cancer (NSCLC), both neoadjuvant therapy (NAT) and adjuvant therapy (AT), is not yet fully elucidated. Methods: We searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCT) that investigated PD-1/PD-L1 inhibitors plus chemotherapy for resectable stage NSCLC. We computed hazard ratios (HRs) or odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs). Results: A total of seven RCTs comprising 3915 patients with resectable stage NSCLC were randomized to chemotherapy with or without PD-1/PD-L1 inhibitors as NAT or AT. As NAT, the PD-1/PD-L1 inhibitors plus chemotherapy group demonstrated significantly improved overall survival (HR 0.66; 95% CI 0.51–0.86) and event-free survival (HR 0.53; 95% CI 0.43–0.67) compared with the chemotherapy alone group. There was a significant increase in favor of the PD-1/PD-L1 inhibitors plus chemotherapy group for major pathological response (OR 6.40; 95% CI 3.86–10.61) and pathological complete response (OR 8.82; 95% CI 4.51–17.26). Meanwhile, as AT, disease-free survival was significant in favor of the PD-1/PD-L1 inhibitors plus chemotherapy group (HR 0.78; 95% CI 0.69–0.90). Conclusions: In this comprehensive systematic review and meta-analysis of RCTs, the incorporation of PD-1/PD-L1 inhibitors alongside chemotherapy offers a promising prospect for reshaping the established treatment paradigms for patients diagnosed with resectable stages of NSCLC. Moreover, our analyses support that neoadjuvant administration with these agents should be encouraged, in light of the fact that it was associated with an increased survival and pathological response, at the expense of a manageable safety profile. |
doi_str_mv | 10.3390/cancers15215143 |
format | Article |
fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2889999495</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A772531718</galeid><sourcerecordid>A772531718</sourcerecordid><originalsourceid>FETCH-LOGICAL-c410t-dc1f7e34dea0bc8e76b3d847466b38232d86ed11294661e55bef437b1f3335de3</originalsourceid><addsrcrecordid>eNptUsFu1DAQjRCVqErPXC1x4ZJuHMdxwi0KlFZaKGoL18ixJ11Xjr3YDtX2s_qFTFskYMVYmhk9vffksSfL3tDihLG2WCnpFIRIeUk5rdiL7LAsRJnXdVu9_Kt_lR3HeFtgMEZFLQ6zh68fcrrCtKbk3G3MaJIPkWztEkm_gdmnDQS53ZHvaL-PddY7IJMP5BIiqCRHC-SLd_nVLK0lPWBaL-6G9E_Xe086crWLCWaZjELNTwN3RDpNPkOSeeek3UUTiZ_IJaJ-NvegSe9dCt5abK-DkTa-zg4mLHD8ux5l304_Xvdn-fri03nfrXNV0SLlWtFJAKs0yGJUDYh6ZLqpRFVj05Ss1E0NmtKyRYQC5yNMFRMjnRhjXAM7yt49-26D_7FATMNsosKZpAO_xKFsmhajajlS3-5Rb_0ScJ4nVlNwXgn2h3UjLQzGTT4FqR5Nh06IkuOX0AZZJ_9h4dEwG4UPPhnE_xGsngUq-BgDTMM2mFmG3UCL4XE7hr3tYL8A0tutwQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2888055473</pqid></control><display><type>article</type><title>PD-1/PD-L1 Inhibitors plus Chemotherapy Versus Chemotherapy Alone for Resectable Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials</title><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>PubMed Central Open Access</source><creator>Pasqualotto, Eric ; Moraes, Francisco Cezar Aquino de ; Chavez, Matheus Pedrotti ; Souza, Maria Eduarda Cavalcanti ; Rodrigues, Anna Luíza Soares de Oliveira ; Ferreira, Rafael Oliva Morgado ; Lopes, Lucca Moreira ; Almeida, Artur Menegaz de ; Fernandes, Marianne Rodrigues ; Santos, Ney Pereira Carneiro dos</creator><creatorcontrib>Pasqualotto, Eric ; Moraes, Francisco Cezar Aquino de ; Chavez, Matheus Pedrotti ; Souza, Maria Eduarda Cavalcanti ; Rodrigues, Anna Luíza Soares de Oliveira ; Ferreira, Rafael Oliva Morgado ; Lopes, Lucca Moreira ; Almeida, Artur Menegaz de ; Fernandes, Marianne Rodrigues ; Santos, Ney Pereira Carneiro dos</creatorcontrib><description>Background: The benefit of adding programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors to the treatment of early-stage non-small cell lung cancer (NSCLC), both neoadjuvant therapy (NAT) and adjuvant therapy (AT), is not yet fully elucidated. Methods: We searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCT) that investigated PD-1/PD-L1 inhibitors plus chemotherapy for resectable stage NSCLC. We computed hazard ratios (HRs) or odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs). Results: A total of seven RCTs comprising 3915 patients with resectable stage NSCLC were randomized to chemotherapy with or without PD-1/PD-L1 inhibitors as NAT or AT. As NAT, the PD-1/PD-L1 inhibitors plus chemotherapy group demonstrated significantly improved overall survival (HR 0.66; 95% CI 0.51–0.86) and event-free survival (HR 0.53; 95% CI 0.43–0.67) compared with the chemotherapy alone group. There was a significant increase in favor of the PD-1/PD-L1 inhibitors plus chemotherapy group for major pathological response (OR 6.40; 95% CI 3.86–10.61) and pathological complete response (OR 8.82; 95% CI 4.51–17.26). Meanwhile, as AT, disease-free survival was significant in favor of the PD-1/PD-L1 inhibitors plus chemotherapy group (HR 0.78; 95% CI 0.69–0.90). Conclusions: In this comprehensive systematic review and meta-analysis of RCTs, the incorporation of PD-1/PD-L1 inhibitors alongside chemotherapy offers a promising prospect for reshaping the established treatment paradigms for patients diagnosed with resectable stages of NSCLC. Moreover, our analyses support that neoadjuvant administration with these agents should be encouraged, in light of the fact that it was associated with an increased survival and pathological response, at the expense of a manageable safety profile.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers15215143</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Adjuvant treatment ; Analysis ; Apoptosis ; Bias ; Cancer ; Cancer therapies ; Care and treatment ; Cell death ; Chemotherapy ; Citation management software ; Clinical trials ; Crizotinib ; Health aspects ; Hypothyroidism ; Immunotherapy ; Kinases ; Ligands ; Lung cancer ; Lung cancer, Non-small cell ; Lung cancer, Small cell ; Lymphatic system ; Meta-analysis ; Metastases ; Metastasis ; Mortality ; Neutrophils ; Non-small cell lung carcinoma ; Patients ; PD-1 protein ; PD-L1 protein ; Small cell lung carcinoma ; Surgery ; Systematic review</subject><ispartof>Cancers, 2023-11, Vol.15 (21), p.5143</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c410t-dc1f7e34dea0bc8e76b3d847466b38232d86ed11294661e55bef437b1f3335de3</citedby><cites>FETCH-LOGICAL-c410t-dc1f7e34dea0bc8e76b3d847466b38232d86ed11294661e55bef437b1f3335de3</cites><orcidid>0000-0002-7244-6461 ; 0000-0003-0623-8135 ; 0000-0001-7213-2350 ; 0009-0004-3869-7373 ; 0000-0002-6484-1162 ; 0000-0002-2770-2198 ; 0000-0002-1396-3442</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids></links><search><creatorcontrib>Pasqualotto, Eric</creatorcontrib><creatorcontrib>Moraes, Francisco Cezar Aquino de</creatorcontrib><creatorcontrib>Chavez, Matheus Pedrotti</creatorcontrib><creatorcontrib>Souza, Maria Eduarda Cavalcanti</creatorcontrib><creatorcontrib>Rodrigues, Anna Luíza Soares de Oliveira</creatorcontrib><creatorcontrib>Ferreira, Rafael Oliva Morgado</creatorcontrib><creatorcontrib>Lopes, Lucca Moreira</creatorcontrib><creatorcontrib>Almeida, Artur Menegaz de</creatorcontrib><creatorcontrib>Fernandes, Marianne Rodrigues</creatorcontrib><creatorcontrib>Santos, Ney Pereira Carneiro dos</creatorcontrib><title>PD-1/PD-L1 Inhibitors plus Chemotherapy Versus Chemotherapy Alone for Resectable Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials</title><title>Cancers</title><description>Background: The benefit of adding programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors to the treatment of early-stage non-small cell lung cancer (NSCLC), both neoadjuvant therapy (NAT) and adjuvant therapy (AT), is not yet fully elucidated. Methods: We searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCT) that investigated PD-1/PD-L1 inhibitors plus chemotherapy for resectable stage NSCLC. We computed hazard ratios (HRs) or odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs). Results: A total of seven RCTs comprising 3915 patients with resectable stage NSCLC were randomized to chemotherapy with or without PD-1/PD-L1 inhibitors as NAT or AT. As NAT, the PD-1/PD-L1 inhibitors plus chemotherapy group demonstrated significantly improved overall survival (HR 0.66; 95% CI 0.51–0.86) and event-free survival (HR 0.53; 95% CI 0.43–0.67) compared with the chemotherapy alone group. There was a significant increase in favor of the PD-1/PD-L1 inhibitors plus chemotherapy group for major pathological response (OR 6.40; 95% CI 3.86–10.61) and pathological complete response (OR 8.82; 95% CI 4.51–17.26). Meanwhile, as AT, disease-free survival was significant in favor of the PD-1/PD-L1 inhibitors plus chemotherapy group (HR 0.78; 95% CI 0.69–0.90). Conclusions: In this comprehensive systematic review and meta-analysis of RCTs, the incorporation of PD-1/PD-L1 inhibitors alongside chemotherapy offers a promising prospect for reshaping the established treatment paradigms for patients diagnosed with resectable stages of NSCLC. Moreover, our analyses support that neoadjuvant administration with these agents should be encouraged, in light of the fact that it was associated with an increased survival and pathological response, at the expense of a manageable safety profile.</description><subject>Adjuvant treatment</subject><subject>Analysis</subject><subject>Apoptosis</subject><subject>Bias</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Cell death</subject><subject>Chemotherapy</subject><subject>Citation management software</subject><subject>Clinical trials</subject><subject>Crizotinib</subject><subject>Health aspects</subject><subject>Hypothyroidism</subject><subject>Immunotherapy</subject><subject>Kinases</subject><subject>Ligands</subject><subject>Lung cancer</subject><subject>Lung cancer, Non-small cell</subject><subject>Lung cancer, Small cell</subject><subject>Lymphatic system</subject><subject>Meta-analysis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Mortality</subject><subject>Neutrophils</subject><subject>Non-small cell lung carcinoma</subject><subject>Patients</subject><subject>PD-1 protein</subject><subject>PD-L1 protein</subject><subject>Small cell lung carcinoma</subject><subject>Surgery</subject><subject>Systematic review</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptUsFu1DAQjRCVqErPXC1x4ZJuHMdxwi0KlFZaKGoL18ixJ11Xjr3YDtX2s_qFTFskYMVYmhk9vffksSfL3tDihLG2WCnpFIRIeUk5rdiL7LAsRJnXdVu9_Kt_lR3HeFtgMEZFLQ6zh68fcrrCtKbk3G3MaJIPkWztEkm_gdmnDQS53ZHvaL-PddY7IJMP5BIiqCRHC-SLd_nVLK0lPWBaL-6G9E_Xe086crWLCWaZjELNTwN3RDpNPkOSeeek3UUTiZ_IJaJ-NvegSe9dCt5abK-DkTa-zg4mLHD8ux5l304_Xvdn-fri03nfrXNV0SLlWtFJAKs0yGJUDYh6ZLqpRFVj05Ss1E0NmtKyRYQC5yNMFRMjnRhjXAM7yt49-26D_7FATMNsosKZpAO_xKFsmhajajlS3-5Rb_0ScJ4nVlNwXgn2h3UjLQzGTT4FqR5Nh06IkuOX0AZZJ_9h4dEwG4UPPhnE_xGsngUq-BgDTMM2mFmG3UCL4XE7hr3tYL8A0tutwQ</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Pasqualotto, Eric</creator><creator>Moraes, Francisco Cezar Aquino de</creator><creator>Chavez, Matheus Pedrotti</creator><creator>Souza, Maria Eduarda Cavalcanti</creator><creator>Rodrigues, Anna Luíza Soares de Oliveira</creator><creator>Ferreira, Rafael Oliva Morgado</creator><creator>Lopes, Lucca Moreira</creator><creator>Almeida, Artur Menegaz de</creator><creator>Fernandes, Marianne Rodrigues</creator><creator>Santos, Ney Pereira Carneiro dos</creator><general>MDPI AG</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7244-6461</orcidid><orcidid>https://orcid.org/0000-0003-0623-8135</orcidid><orcidid>https://orcid.org/0000-0001-7213-2350</orcidid><orcidid>https://orcid.org/0009-0004-3869-7373</orcidid><orcidid>https://orcid.org/0000-0002-6484-1162</orcidid><orcidid>https://orcid.org/0000-0002-2770-2198</orcidid><orcidid>https://orcid.org/0000-0002-1396-3442</orcidid></search><sort><creationdate>20231101</creationdate><title>PD-1/PD-L1 Inhibitors plus Chemotherapy Versus Chemotherapy Alone for Resectable Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials</title><author>Pasqualotto, Eric ; Moraes, Francisco Cezar Aquino de ; Chavez, Matheus Pedrotti ; Souza, Maria Eduarda Cavalcanti ; Rodrigues, Anna Luíza Soares de Oliveira ; Ferreira, Rafael Oliva Morgado ; Lopes, Lucca Moreira ; Almeida, Artur Menegaz de ; Fernandes, Marianne Rodrigues ; Santos, Ney Pereira Carneiro dos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c410t-dc1f7e34dea0bc8e76b3d847466b38232d86ed11294661e55bef437b1f3335de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adjuvant treatment</topic><topic>Analysis</topic><topic>Apoptosis</topic><topic>Bias</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Cell death</topic><topic>Chemotherapy</topic><topic>Citation management software</topic><topic>Clinical trials</topic><topic>Crizotinib</topic><topic>Health aspects</topic><topic>Hypothyroidism</topic><topic>Immunotherapy</topic><topic>Kinases</topic><topic>Ligands</topic><topic>Lung cancer</topic><topic>Lung cancer, Non-small cell</topic><topic>Lung cancer, Small cell</topic><topic>Lymphatic system</topic><topic>Meta-analysis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Mortality</topic><topic>Neutrophils</topic><topic>Non-small cell lung carcinoma</topic><topic>Patients</topic><topic>PD-1 protein</topic><topic>PD-L1 protein</topic><topic>Small cell lung carcinoma</topic><topic>Surgery</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pasqualotto, Eric</creatorcontrib><creatorcontrib>Moraes, Francisco Cezar Aquino de</creatorcontrib><creatorcontrib>Chavez, Matheus Pedrotti</creatorcontrib><creatorcontrib>Souza, Maria Eduarda Cavalcanti</creatorcontrib><creatorcontrib>Rodrigues, Anna Luíza Soares de Oliveira</creatorcontrib><creatorcontrib>Ferreira, Rafael Oliva Morgado</creatorcontrib><creatorcontrib>Lopes, Lucca Moreira</creatorcontrib><creatorcontrib>Almeida, Artur Menegaz de</creatorcontrib><creatorcontrib>Fernandes, Marianne Rodrigues</creatorcontrib><creatorcontrib>Santos, Ney Pereira Carneiro dos</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Cancers</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pasqualotto, Eric</au><au>Moraes, Francisco Cezar Aquino de</au><au>Chavez, Matheus Pedrotti</au><au>Souza, Maria Eduarda Cavalcanti</au><au>Rodrigues, Anna Luíza Soares de Oliveira</au><au>Ferreira, Rafael Oliva Morgado</au><au>Lopes, Lucca Moreira</au><au>Almeida, Artur Menegaz de</au><au>Fernandes, Marianne Rodrigues</au><au>Santos, Ney Pereira Carneiro dos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>PD-1/PD-L1 Inhibitors plus Chemotherapy Versus Chemotherapy Alone for Resectable Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials</atitle><jtitle>Cancers</jtitle><date>2023-11-01</date><risdate>2023</risdate><volume>15</volume><issue>21</issue><spage>5143</spage><pages>5143-</pages><issn>2072-6694</issn><eissn>2072-6694</eissn><abstract>Background: The benefit of adding programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors to the treatment of early-stage non-small cell lung cancer (NSCLC), both neoadjuvant therapy (NAT) and adjuvant therapy (AT), is not yet fully elucidated. Methods: We searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCT) that investigated PD-1/PD-L1 inhibitors plus chemotherapy for resectable stage NSCLC. We computed hazard ratios (HRs) or odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs). Results: A total of seven RCTs comprising 3915 patients with resectable stage NSCLC were randomized to chemotherapy with or without PD-1/PD-L1 inhibitors as NAT or AT. As NAT, the PD-1/PD-L1 inhibitors plus chemotherapy group demonstrated significantly improved overall survival (HR 0.66; 95% CI 0.51–0.86) and event-free survival (HR 0.53; 95% CI 0.43–0.67) compared with the chemotherapy alone group. There was a significant increase in favor of the PD-1/PD-L1 inhibitors plus chemotherapy group for major pathological response (OR 6.40; 95% CI 3.86–10.61) and pathological complete response (OR 8.82; 95% CI 4.51–17.26). Meanwhile, as AT, disease-free survival was significant in favor of the PD-1/PD-L1 inhibitors plus chemotherapy group (HR 0.78; 95% CI 0.69–0.90). Conclusions: In this comprehensive systematic review and meta-analysis of RCTs, the incorporation of PD-1/PD-L1 inhibitors alongside chemotherapy offers a promising prospect for reshaping the established treatment paradigms for patients diagnosed with resectable stages of NSCLC. Moreover, our analyses support that neoadjuvant administration with these agents should be encouraged, in light of the fact that it was associated with an increased survival and pathological response, at the expense of a manageable safety profile.</abstract><cop>Basel</cop><pub>MDPI AG</pub><doi>10.3390/cancers15215143</doi><orcidid>https://orcid.org/0000-0002-7244-6461</orcidid><orcidid>https://orcid.org/0000-0003-0623-8135</orcidid><orcidid>https://orcid.org/0000-0001-7213-2350</orcidid><orcidid>https://orcid.org/0009-0004-3869-7373</orcidid><orcidid>https://orcid.org/0000-0002-6484-1162</orcidid><orcidid>https://orcid.org/0000-0002-2770-2198</orcidid><orcidid>https://orcid.org/0000-0002-1396-3442</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 2072-6694 |
ispartof | Cancers, 2023-11, Vol.15 (21), p.5143 |
issn | 2072-6694 2072-6694 |
language | eng |
recordid | cdi_proquest_miscellaneous_2889999495 |
source | MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central; PubMed Central Open Access |
subjects | Adjuvant treatment Analysis Apoptosis Bias Cancer Cancer therapies Care and treatment Cell death Chemotherapy Citation management software Clinical trials Crizotinib Health aspects Hypothyroidism Immunotherapy Kinases Ligands Lung cancer Lung cancer, Non-small cell Lung cancer, Small cell Lymphatic system Meta-analysis Metastases Metastasis Mortality Neutrophils Non-small cell lung carcinoma Patients PD-1 protein PD-L1 protein Small cell lung carcinoma Surgery Systematic review |
title | PD-1/PD-L1 Inhibitors plus Chemotherapy Versus Chemotherapy Alone for Resectable Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T12%3A52%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=PD-1/PD-L1%20Inhibitors%20plus%20Chemotherapy%20Versus%20Chemotherapy%20Alone%20for%20Resectable%20Non-Small%20Cell%20Lung%20Cancer:%20A%20Systematic%20Review%20and%20Meta-Analysis%20of%20Randomized%20Controlled%20Trials&rft.jtitle=Cancers&rft.au=Pasqualotto,%20Eric&rft.date=2023-11-01&rft.volume=15&rft.issue=21&rft.spage=5143&rft.pages=5143-&rft.issn=2072-6694&rft.eissn=2072-6694&rft_id=info:doi/10.3390/cancers15215143&rft_dat=%3Cgale_proqu%3EA772531718%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2888055473&rft_id=info:pmid/&rft_galeid=A772531718&rfr_iscdi=true |