Efficacy and Safety of Perioperative Immunotherapy for Patients with Non-Small Cell Lung Cancer: A Systematic Review and Network Meta-Analysis
<b>Background:</b> The objective of this study is to indirectly compare the efficacy and safety of all currently available neoadjuvant chemoimmunotherapy and perioperative chemoimmunotherapy in randomized controlled trials (RCTs) involving patients with resectable non-small cell lung can...
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| Language: | English |
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MDPI AG
2025-03-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/32/3/184 |
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| author | Zhijuan Du Siyuan Chen Yuhui Qin Yahui Lv Xiangyu Du Heying Yu Zhefeng Liu |
| author_facet | Zhijuan Du Siyuan Chen Yuhui Qin Yahui Lv Xiangyu Du Heying Yu Zhefeng Liu |
| author_sort | Zhijuan Du |
| collection | DOAJ |
| description | <b>Background:</b> The objective of this study is to indirectly compare the efficacy and safety of all currently available neoadjuvant chemoimmunotherapy and perioperative chemoimmunotherapy in randomized controlled trials (RCTs) involving patients with resectable non-small cell lung cancer (NSCLC) to identify optimal treatment regimens. <b>Methods:</b> Eligible studies evaluating neoadjuvant chemoimmunotherapy and perioperative chemoimmunotherapy-based regimens in resectable NSCLC patients were included. Clinical outcomes were extracted for event-free survival (EFS) and overall survival (OS), as well as the incidence of pathological complete response (pCR), major pathological response (MPR), any-grade adverse events (AEs), and treatment-related adverse events (TRAEs) in the Bayesian framework. A subgroup analysis of EFS was conducted according to PD-L1 expression, histological type and reaching pCR or not. <b>Results:</b> We selected eight RCTs involving 3113 patients. Our analysis found no significant differences between perioperative immunotherapy and neoadjuvant immunotherapy in terms of MPR (RR 0.72, 95% CI 0.39 –1.3), pCR (RR 0.73, 95% CI 0.24–2.3), EFS (HR 0.95, 95% CI 0.56–1.7), and OS (HR 95% CI 3.9–4.2). Subgroup analyses revealed that neoadjuvant immunotherapy demonstrated superiority in the programmed death-ligand 1 (PD-L1) high-expression cohort, the non-squamous cell carcinoma cohort, and the non-smoking cohort. Conversely, perioperative immunotherapy ranked first in the PD-L1 low-expression cohort, squamous cell carcinoma cohort, and non-pCR cohort. <b>Conclusions:</b> Our findings indicate that neoadjuvant immunotherapy and perioperative immunotherapy exhibit comparable efficacy in patients with NSCLC. These results provide valuable evidence for guiding the treatment of patients with resectable NSCLC. |
| format | Article |
| id | doaj-art-fa5c9ac1fc544fedbcb0d187fe28c008 |
| institution | Kabale University |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj-art-fa5c9ac1fc544fedbcb0d187fe28c0082025-08-20T03:43:33ZengMDPI AGCurrent Oncology1198-00521718-77292025-03-0132318410.3390/curroncol32030184Efficacy and Safety of Perioperative Immunotherapy for Patients with Non-Small Cell Lung Cancer: A Systematic Review and Network Meta-AnalysisZhijuan Du0Siyuan Chen1Yuhui Qin2Yahui Lv3Xiangyu Du4Heying Yu5Zhefeng Liu6Medical School of Chinese PLA, Beijing 100853, ChinaMedical School of Chinese PLA, Beijing 100853, ChinaMedical School of Chinese PLA, Beijing 100853, ChinaMedical School of Chinese PLA, Beijing 100853, ChinaMedical School of Chinese PLA, Beijing 100853, ChinaDepartment of Medical Oncology, The Third Medical Center of Chinese PLA General Hospital, Beijing 100089, ChinaDepartment of Medical Oncology, Senior Department of Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China<b>Background:</b> The objective of this study is to indirectly compare the efficacy and safety of all currently available neoadjuvant chemoimmunotherapy and perioperative chemoimmunotherapy in randomized controlled trials (RCTs) involving patients with resectable non-small cell lung cancer (NSCLC) to identify optimal treatment regimens. <b>Methods:</b> Eligible studies evaluating neoadjuvant chemoimmunotherapy and perioperative chemoimmunotherapy-based regimens in resectable NSCLC patients were included. Clinical outcomes were extracted for event-free survival (EFS) and overall survival (OS), as well as the incidence of pathological complete response (pCR), major pathological response (MPR), any-grade adverse events (AEs), and treatment-related adverse events (TRAEs) in the Bayesian framework. A subgroup analysis of EFS was conducted according to PD-L1 expression, histological type and reaching pCR or not. <b>Results:</b> We selected eight RCTs involving 3113 patients. Our analysis found no significant differences between perioperative immunotherapy and neoadjuvant immunotherapy in terms of MPR (RR 0.72, 95% CI 0.39 –1.3), pCR (RR 0.73, 95% CI 0.24–2.3), EFS (HR 0.95, 95% CI 0.56–1.7), and OS (HR 95% CI 3.9–4.2). Subgroup analyses revealed that neoadjuvant immunotherapy demonstrated superiority in the programmed death-ligand 1 (PD-L1) high-expression cohort, the non-squamous cell carcinoma cohort, and the non-smoking cohort. Conversely, perioperative immunotherapy ranked first in the PD-L1 low-expression cohort, squamous cell carcinoma cohort, and non-pCR cohort. <b>Conclusions:</b> Our findings indicate that neoadjuvant immunotherapy and perioperative immunotherapy exhibit comparable efficacy in patients with NSCLC. These results provide valuable evidence for guiding the treatment of patients with resectable NSCLC.https://www.mdpi.com/1718-7729/32/3/184non-small cell lung cancerimmune checkpoint inhibitorperioperative immunotherapyBayesian network meta-analysis |
| spellingShingle | Zhijuan Du Siyuan Chen Yuhui Qin Yahui Lv Xiangyu Du Heying Yu Zhefeng Liu Efficacy and Safety of Perioperative Immunotherapy for Patients with Non-Small Cell Lung Cancer: A Systematic Review and Network Meta-Analysis Current Oncology non-small cell lung cancer immune checkpoint inhibitor perioperative immunotherapy Bayesian network meta-analysis |
| title | Efficacy and Safety of Perioperative Immunotherapy for Patients with Non-Small Cell Lung Cancer: A Systematic Review and Network Meta-Analysis |
| title_full | Efficacy and Safety of Perioperative Immunotherapy for Patients with Non-Small Cell Lung Cancer: A Systematic Review and Network Meta-Analysis |
| title_fullStr | Efficacy and Safety of Perioperative Immunotherapy for Patients with Non-Small Cell Lung Cancer: A Systematic Review and Network Meta-Analysis |
| title_full_unstemmed | Efficacy and Safety of Perioperative Immunotherapy for Patients with Non-Small Cell Lung Cancer: A Systematic Review and Network Meta-Analysis |
| title_short | Efficacy and Safety of Perioperative Immunotherapy for Patients with Non-Small Cell Lung Cancer: A Systematic Review and Network Meta-Analysis |
| title_sort | efficacy and safety of perioperative immunotherapy for patients with non small cell lung cancer a systematic review and network meta analysis |
| topic | non-small cell lung cancer immune checkpoint inhibitor perioperative immunotherapy Bayesian network meta-analysis |
| url | https://www.mdpi.com/1718-7729/32/3/184 |
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