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新辅助化疗免疫治疗早期三阴性乳腺癌的病理完全缓解:一项更新的荟萃分析。

Pathological Complete Response to Neoadjuvant Chemoimmunotherapy for Early Triple-Negative Breast Cancer: An Updated Meta-Analysis.

机构信息

Struttura Semplice Dipartimentale di Oncologia Medica per la Presa in Carico Globale del Paziente Oncologico "Don Tonino Bello", IRCCS, Istituto Tumori "Giovanni Paolo II", Viale Orazio Flacco 65, 70124 Bari, Italy.

Struttura Semplice Dipartimentale di Fisica Sanitaria, IRCCS, Istituto Tumori "Giovanni Paolo II", Viale Orazio Flacco 65, 70124 Bari, Italy.

出版信息

Cells. 2022 Jun 7;11(12):1857. doi: 10.3390/cells11121857.

Abstract

Immune checkpoint inhibitors (ICIs) have made a breakthrough in the systemic treatment for metastatic triple-negative breast cancer (TNBC) patients. However, results of phase II and III clinical trials assessing ICIs plus chemotherapy as neoadjuvant treatment were controversial and conflicting. We performed a meta-analysis aimed at assessing the Odds Ratio (OR) of the pathological complete response (pCR) rate in trials assessing neoadjuvant chemoimmunotherapy in TNBC. According to our results, the use of neoadjuvant chemoimmunotherapy was associated with higher pCR (OR 1.95; 95% Confidence Intervals, 1.27-2.99). In addition, we highlighted that this benefit was observed regardless of PD-L1 status since the analysis reported a statistically significant and clinically meaningful benefit in both PD-L1 positive and PD-L1 negative patients. These findings further support the exploration of the role of ICIs plus chemotherapy in early-stage TNBC, given the potentially meaningful clinical impact of these agents. Further studies aimed at more deeply investigating this emerging topic in breast cancer immunotherapy are warranted.

摘要

免疫检查点抑制剂(ICIs)在转移性三阴性乳腺癌(TNBC)患者的全身治疗方面取得了突破。然而,评估 ICIs 联合化疗作为新辅助治疗的 II 期和 III 期临床试验结果存在争议和矛盾。我们进行了一项荟萃分析,旨在评估评估 TNBC 新辅助化疗免疫治疗的临床试验中病理完全缓解(pCR)率的优势比(OR)。根据我们的结果,新辅助化疗免疫治疗与更高的 pCR 相关(OR 1.95;95%置信区间,1.27-2.99)。此外,我们强调,这种益处与 PD-L1 状态无关,因为分析报告称在 PD-L1 阳性和 PD-L1 阴性患者中均观察到具有统计学意义和临床意义的益处。这些发现进一步支持探索 ICIs 联合化疗在早期 TNBC 中的作用,因为这些药物具有潜在的有意义的临床影响。需要进一步的研究来更深入地研究乳腺癌免疫治疗中这一新兴课题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14a5/9221459/95219cbe685e/cells-11-01857-g001.jpg

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