Department of Experimental Medicine, Sapienza University, Rome, Italy; Division of Medical Oncology B, Policlinico Umberto I, Rome, Italy.
Thoracic Surgery Unit, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy.
Crit Rev Oncol Hematol. 2023 Dec;192:104190. doi: 10.1016/j.critrevonc.2023.104190. Epub 2023 Oct 21.
The use of neoadjuvant or perioperative anti-PD(L)1 was recently tested in multiple clinical trials. We performed a systematic review and meta-analysis of randomised trials comparing neoadjuvant or perioperative chemoimmunotherapy to neoadjuvant chemotherapy in resectable NSCLC. Nine reports from 6 studies were included. Receipt of surgery was more frequent in the experimental arm (odds ratio, OR 1.39) as was pCR (OR 7.60). EFS was improved in the experimental arm (hazard ratio, HR 0.55) regardless of stage, histology, PD-L1 expression (PD-L1 negative, HR 0.74) and smoking exposure (never smokers, HR 0.67), as was OS (HR 0.67). Grade > = 3 treatment-related adverse events were more frequent in the experimental arm (OR 1.22). The experimental treatment improved surgical outcomes, pCR rates, EFS and OS in stage II-IIIB, EGFR/ALK negative resectable NSCLC; confirmatory evidence is warranted for stage IIIB tumours and with higher maturity of the OS endpoint.
新辅助或围手术期抗 PD(L)1 治疗最近在多项临床试验中得到了检验。我们对比较新辅助化疗与新辅助化疗联合围手术期化疗治疗可切除 NSCLC 的随机试验进行了系统评价和荟萃分析。纳入了来自 6 项研究的 9 份报告。实验组更频繁地接受了手术（比值比，OR 1.39），pCR 也更常见（OR 7.60）。无论分期、组织学、PD-L1 表达（PD-L1 阴性，HR 0.74）和吸烟状况（从不吸烟者，HR 0.67）如何，实验组的无进展生存期（HR 0.55）和总生存期（HR 0.67）均得到改善。实验组更频繁地出现> = 3 级治疗相关不良事件（OR 1.22）。在 II 期-IIIB 期、EGFR/ALK 阴性可切除 NSCLC 中，实验组治疗提高了手术结局、pCR 率、无进展生存期和总生存期；需要对 IIIB 期肿瘤进行确证性证据，并对 OS 终点进行更高水平的成熟度评估。
Zotero 插件