Li Shen, Xu Chenhao, Meng Yuanling, Li Yiyang, Yang Jiaqing, Du Junxuan, Zhang Fan, Liao Hu, Ma Xuelei
Department of Biotherapy West China Hospital and State Key Laboratory of Biotherapy Sichuan University Chengdu China.
West China School of Medicine West China Hospital Sichuan University Chengdu Sichuan China.
MedComm (2020). 2025 May 31;6(6):e70211. doi: 10.1002/mco2.70211. eCollection 2025 Jun.
This study explores the efficacy and safety of combining immunotherapy with chemotherapy for neoadjuvant non-small cell lung cancer (NSCLC) treatment. Despite the rapid advancement of immunotherapy, direct evidence comparing it with chemotherapy alone is limited. Following PRISMA guidelines, we analyzed global phase II and III randomized controlled trials data. Our meta-analysis included nine trials with 3431 participants, showing that combined treatment significantly improved event-free survival, pathological complete response, major pathological response, surgical acceptance, and R0 resection rates in NSCLC compared with chemotherapy alone. Safety analysis revealed similar all adverse event incidences between treatments, while Grade ≥3 adverse events were higher than those in neoadjuvant chemotherapy. Network meta-analysis confirmed the benefits of different immunotherapeutic drugs and efficacy in different subgroups. The study's high-quality evidence suggests that neoadjuvant immunotherapy plus chemotherapy should be considered in clinical practice for NSCLC, with further research needed to optimize treatment strategies and improve patient outcomes.
本研究探讨免疫疗法联合化疗用于新辅助治疗非小细胞肺癌（NSCLC）的疗效和安全性。尽管免疫疗法发展迅速，但将其与单纯化疗进行比较的直接证据有限。遵循PRISMA指南，我们分析了全球II期和III期随机对照试验数据。我们的荟萃分析纳入了9项试验，共3431名参与者，结果表明，与单纯化疗相比，联合治疗显著提高了NSCLC患者的无事件生存期、病理完全缓解率、主要病理缓解率、手术可接受率和R0切除率。安全性分析显示，两种治疗的所有不良事件发生率相似，但≥3级不良事件高于新辅助化疗。网络荟萃分析证实了不同免疫治疗药物的益处以及在不同亚组中的疗效。该研究的高质量证据表明，在NSCLC的临床实践中应考虑新辅助免疫疗法联合化疗，还需要进一步研究以优化治疗策略并改善患者预后。
