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Meta-Analysis
. 2023 Dec 1:14:1273220.
doi: 10.3389/fimmu.2023.1273220. eCollection 2023.

Efficacy, safety, and survival of neoadjuvant immunochemotherapy in operable non-small cell lung cancer: a systematic review and meta-analysis

Yue Zheng #  1 , Baijie Feng #  1 , Jingyao Chen #  2 , Liting You  3
Affiliations
Meta-Analysis

Efficacy, safety, and survival of neoadjuvant immunochemotherapy in operable non-small cell lung cancer: a systematic review and meta-analysis

Yue Zheng et al. Front Immunol. .

Abstract

Background: Neoadjuvant immunochemotherapy may benefit patients with non-small cell lung cancer (NSCLC), but its impact requires further investigation VSports手机版. .

Methods: A meta-analysis was conducted. PubMed, Embase, Web of Science, and the Cochrane Library were searched. The study was registered in PROSPERO (registration no. CRD42022360893) V体育安卓版. .

Results: 60 studies of 3,632 patients were included. Comparing with neoadjuvant chemotherapy, neoadjuvant immunochemotherapy showed higher pCR (RR: 4. 71, 95% CI: 3. 69, 6. 02), MPR (RR, 3. 20, 95% CI: 2. 75, 3. 74), and ORR (RR, 1. 46, 95% CI: 1. 21, 1. 77), fewer surgical complications (RR: 0. 67, 95%CI: 0. 48, 0. 94), higher R0 resection rate (RR: 1. 06, 95%CI: 1. 03, 1. 10, I2 = 52%), and longer 1-year and 2-year OS, without affecting TRAEs. For neoadjuvant immunochemotherapy in NSCLC, the pooled pCR rate was 0. 35 (95% CI: 0. 31, 0. 39), MPR was 0. 59 (95% CI: 0. 54, 0. 63), and ORR was 0. 71 (95% CI: 0. 66, 0. 76). The pooled incidence of all grade TRAEs was 0. 70 (95% CI: 0. 60, 0. 81), and that of >= grade 3 TRAEs was 0. 24 (95% CI: 0. 16, 0. 32). The surgical complications rate was 0. 13 (95% CI: 0. 07, 0. 18) and R0 resection rate was 0. 98 (95% CI: 0. 96, 0. 99). The pooled 1-year OS was 0. 97 (95%CI: 0. 96, 0. 99), and 2-year OS was 0. 89 (95%CI: 0. 83, 0. 94). Patients with squamous cell carcinoma, stage III or higher PD-L1 performed better. Notably, no significant differences were observed in pCR, MPR, and ORR between 2 or more treatment cycles. Pembrolizumab-, or toripalimab-based neoadjuvant immunochemotherapy demonstrated superior efficacy and tolerable toxicity. V体育ios版.

Conclusion: According to our analysis, reliable efficacy, safety, and survival of neoadjuvant immunochemotherapy for operable NSCLC were demonstrated VSports最新版本. .

Systematic review registration: https://www. crd. york. ac. uk/prospero/display_record. php. ID=CRD42022360893, identifier CRD42022360893. V体育平台登录.

Keywords: efficacy; neoadjuvant immunochemotherapy; non-small cell lung cancer; safety; survival VSports注册入口. .

PubMed Disclaimer

Conflict of interest statement (VSports手机版)

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

"VSports app下载" Figures

Figure 1
Figure 1
PRISMA diagram of identifying eligible studies.
Figure 2
Figure 2
Comparison of efficacy, safety and survival between neoadjuvant immunochemotherapy with neoadjuvant chemotherapy alone. (A) Comparison of pCR; (B) Comparison of MPR; (C) Comparison of >= 3 Grade TRAEs; (D) Comparison of 1-year OS; (E) Comparison of 2-year OS.
Figure 3
Figure 3
Efficacy of neoadjuvant immunochemotherapy in resectable non-small cell lung cancer. (A) pCR of neoadjuvant immunochemotherapy in resectable non-small cell lung cancer; (B) MPR of neoadjuvant immunochemotherapy in resectable non-small cell lung cancer; (C) ORR of neoadjuvant immunochemotherapy in resectable non-small cell lung cancer.
Figure 4
Figure 4
Safety and survival of neoadjuvant immunochemotherapy in resectable non-small cell lung cancer. (A) >= 3 Grade TRAEs of neoadjuvant immunochemotherapy in resectable non-small cell lung cancer; (B) 1-year OS of neoadjuvant immunochemotherapy in resectable non-small cell lung cancer; (C) 2-year OS of neoadjuvant immunochemotherapy in resectable non-small cell lung cancer.
Figure 5
Figure 5
Subgroup analysis of pCR by clinical characteristics.
See this image and copyright information in PMC

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