{"title":"Efficacy and Safety of PD-1/PD-L1 Inhibitors in Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis","authors":"Zhen-Yu Li, Zhen Zhang, Xiao-Zhong Cao, Yun Feng, Sha-Sha Ren","doi":"10.31083/j.ceog5009185","DOIUrl":null,"url":null,"abstract":"Background: Compared with other subtypes, triple-negative breast cancer (TNBC) is more aggressive and has a lower survival rate with chemotherapy being the only acknowledged systemic treatment option. Recently, PD-1/PD-L1 (programmed cell death-1 and programmed death-ligand 1) inhibitors have demonstrated survival benefits in locally advanced or metastatic TNBC patients. However, the effects of PD-1/PD-L1 inhibitors in neoadjuvant chemotherapy remain controversial. Methods: Extensive literature searches were conducted in the PubMed, Embase and Cochrane databases. A pooled odds ratio (OR) with 95% confidence intervals (CI) was analyzed. Results: Seven randomized controlled trials (N = 1707) were included. PD-1/PD-L1 inhibitor chemotherapy group showed pathological complete response (pCR) benefit of 59.0% vs. 40.4% (OR 1.98, 95% CI 1.38–2.82, p < 0.001). Hematological adverse events were similar. There was no significant difference between the two groups in terms of anemia (OR 1.25, 95% CI 0.93–1.68, p = 0.14; I2 = 0%, p = 0.99) or neutropenia (OR 1.00, 95% CI 0.82–1.21, p = 0.96; I2 = 0%, p = 0.70). Conclusions: Adding PD-1/PD-L1 inhibitors to neoadjuvant chemotherapy can improve pCR rates in TNBC patients without increasing hematological toxicities. The data suggests that PD-1/PD-L1 inhibitors may be a viable option for patients with TNBC.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"27 1","pages":"0"},"PeriodicalIF":0.4000,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and experimental obstetrics & gynecology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.31083/j.ceog5009185","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Compared with other subtypes, triple-negative breast cancer (TNBC) is more aggressive and has a lower survival rate with chemotherapy being the only acknowledged systemic treatment option. Recently, PD-1/PD-L1 (programmed cell death-1 and programmed death-ligand 1) inhibitors have demonstrated survival benefits in locally advanced or metastatic TNBC patients. However, the effects of PD-1/PD-L1 inhibitors in neoadjuvant chemotherapy remain controversial. Methods: Extensive literature searches were conducted in the PubMed, Embase and Cochrane databases. A pooled odds ratio (OR) with 95% confidence intervals (CI) was analyzed. Results: Seven randomized controlled trials (N = 1707) were included. PD-1/PD-L1 inhibitor chemotherapy group showed pathological complete response (pCR) benefit of 59.0% vs. 40.4% (OR 1.98, 95% CI 1.38–2.82, p < 0.001). Hematological adverse events were similar. There was no significant difference between the two groups in terms of anemia (OR 1.25, 95% CI 0.93–1.68, p = 0.14; I2 = 0%, p = 0.99) or neutropenia (OR 1.00, 95% CI 0.82–1.21, p = 0.96; I2 = 0%, p = 0.70). Conclusions: Adding PD-1/PD-L1 inhibitors to neoadjuvant chemotherapy can improve pCR rates in TNBC patients without increasing hematological toxicities. The data suggests that PD-1/PD-L1 inhibitors may be a viable option for patients with TNBC.
背景:与其他亚型相比,三阴性乳腺癌(TNBC)更具侵袭性,生存率较低,化疗是唯一公认的全身治疗选择。最近,PD-1/PD-L1(程序性细胞死亡-1和程序性死亡配体1)抑制剂在局部晚期或转移性TNBC患者中显示出生存益处。然而,PD-1/PD-L1抑制剂在新辅助化疗中的作用仍然存在争议。方法:在PubMed、Embase和Cochrane数据库中进行广泛的文献检索。分析合并优势比(OR)和95%置信区间(CI)。结果:纳入7项随机对照试验(N = 1707)。PD-1/PD-L1抑制剂化疗组病理完全缓解(pCR)获益为59.0% vs 40.4% (OR 1.98, 95% CI 1.38-2.82, p <0.001)。血液学不良事件相似。两组在贫血方面无显著差异(OR 1.25, 95% CI 0.93-1.68, p = 0.14;I2 = 0%, p = 0.99)或中性粒细胞减少症(or 1.00, 95% CI 0.82-1.21, p = 0.96;I2 = 0%, p = 0.70)。结论:在新辅助化疗中加入PD-1/PD-L1抑制剂可提高TNBC患者的pCR率,且不会增加血液毒性。数据表明,PD-1/PD-L1抑制剂可能是TNBC患者的可行选择。
期刊介绍:
CEOG is an international, peer-reviewed, open access journal. CEOG covers all aspects of Obstetrics and Gynecology, including obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine. All submissions of cutting-edge advances of medical research in the area of women''s health worldwide are encouraged.