Cancer treatment reviews最新文献

{"title":"Management of infections in the outpatient care of patients with cancer","authors":"Michael Sandherr ,&nbsp;Georg Maschmeyer ,&nbsp;Christina Rieger","doi":"10.1016/j.ctrv.2026.103142","DOIUrl":"10.1016/j.ctrv.2026.103142","url":null,"abstract":"<div><div>Infections are a common complication in immunocompromised patients with haematological and oncological diseases, including in outpatient settings. They lead to distressing morbidity and can delay or jeopardize the implementation of effective antineoplastic therapy. Identifying risk groups for complicated infections may reduce morbidity and mortality. The prevention of bacterial and viral infections as well as Pneumocystis jirovecii pneumonia through drug prophylaxis and consistent vaccination are essential here. In many cases, precise clinical evaluation of patients with febrile neutropenia allows for outpatient empirical and pre-emptive oral antimicrobial therapy and avoids unnecessary hospital stays.</div><div>These recommendations are based on guidelines developed by the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO) for the prophylaxis, diagnosis, and treatment of these patients, which are available on the Onkopedia platform of the DGHO (<span><span>www.onkopedia.com</span><svg><path></path></svg></span>). The recommendations are backed-up by systematic literature reviews, uniform assessment of the strength of evidence, and a consensus-building process.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"146 ","pages":"Article 103142"},"PeriodicalIF":10.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Streptozotocin revisited: Pharmacological determinants supporting new scheduling strategies in neuroendocrine tumours","authors":"Nicola Fazio ,&nbsp;Francesca Spada ,&nbsp;Lavinia Benini ,&nbsp;Cristiana Mulargiu ,&nbsp;Marzia Del Re ,&nbsp;Romano Danesi","doi":"10.1016/j.ctrv.2026.103140","DOIUrl":"10.1016/j.ctrv.2026.103140","url":null,"abstract":"<div><div>Streptozotocin (STZ) remains a potentially effective chemotherapeutic agent for pancreatic neuroendocrine tumours, more than five decades after its initial use. Despite its longstanding clinical application, STZ dosing regimens have traditionally been driven by empirical practice rather than by pharmacokinetic or pharmacodynamic rationale. Recent advances in understanding its molecular mechanism of action, selective uptake via the glucose transporter type 2 transporter, and DNA-methylating properties provide a solid foundation for revisiting its therapeutic role and optimising its scheduling.</div><div>This review outlines the key pharmacological features of STZ, including its rapid systemic clearance, narrow volume of distribution, and renal elimination, all of which support the use of short intravenous infusions and fractionated schedules to minimise nephrotoxicity while maintaining efficacy. Comparative insights with temozolomide highlight the unique delivery and tissue tropism advantages of STZ, particularly in pancreatic neuroendocrine tumours. In addition, emerging biomarkers, such as O⁶-methylguanine-DNA methyltransferase deficiency and mismatch repair status, may help refine patient selection for STZ-based chemotherapy.</div><div>Clinical data from classical and modern regimens, such as those combining STZ with 5-fluorouracil or capecitabine, suggest sustained disease control in well-selected patients. The potential for biomarker-guided strategies and pharmacology-informed protocols supports a contemporary repositioning of STZ in neuroendocrine oncology. Rational redesign of dosing, improved toxicity management, and integration with personalised medicine may revitalise the clinical utility of this historically valuable agent.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"146 ","pages":"Article 103140"},"PeriodicalIF":10.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the therapeutic Frontier: Liver transplantation for unresectable colorectal liver metastases","authors":"Alex B. Munster ,&nbsp;Umair Mahmood ,&nbsp;Heather Fuller ,&nbsp;Hajun Seo ,&nbsp;Jamie Murphy ,&nbsp;Krishna Menon ,&nbsp;Charles Imber ,&nbsp;Chetan Bhan ,&nbsp;Khurum Khan","doi":"10.1016/j.ctrv.2026.103139","DOIUrl":"10.1016/j.ctrv.2026.103139","url":null,"abstract":"<div><div>A substantial proportion of patients with colorectal cancer present with or ultimately develop metastatic disease confined to the liver. The management of colorectal liver metastases remains one of the most complex and debated areas in oncological practice, with curative resection feasible in only a minority of cases. However, emerging evidence, most notably from the TransMet study, has reshaped the therapeutic landscape. The demonstration of a clear survival advantage in carefully selected patients with unresectable hepatic disease undergoing liver transplantation represents a transformative advance and challenges longstanding treatment paradigms. This narrative review critically appraises the epidemiological burden of colorectal liver metastases and delineates the key biological and clinical determinants underpinning their development. We synthesise the pivotal clinical trial data establishing the rationale for liver transplantation in this population and define the parameters for appropriate patient selection. The evolving perioperative integration of systemic therapies and the optimisation of postoperative surveillance strategies are examined in detail. Finally, we evaluate the emerging role of liquid biopsy as a precision tool to refine risk stratification and guide management, while addressing the ethical, logistical, and immunological considerations inherent to expanding transplant indications in this setting.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"146 ","pages":"Article 103139"},"PeriodicalIF":10.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hematological immune-related adverse events associated with checkpoint inhibitors","authors":"Mélanie Janson ,&nbsp;François Cherifi ,&nbsp;Hippolyte Bardet ,&nbsp;Gandhi Damaj","doi":"10.1016/j.ctrv.2026.103121","DOIUrl":"10.1016/j.ctrv.2026.103121","url":null,"abstract":"<div><h3>Background</h3><div>The use of immune checkpoint inhibitors (ICIs) has expanded substantially across tumor types, establishing them as a cornerstone of modern oncology. However, the frequency and severity of immune-related adverse events (irAEs) remain underestimated, particularly hematologic toxicities, which can be life-threatening and require distinct management approaches compared to cytotoxic or targeted therapies.</div></div><div><h3>Methods</h3><div>We performed literature reviews using PubMed to identify and analyze reported cases of the most frequent hematologic irAEs; autoimmune hemolytic anemia (AIHA), immune thrombocytopenia (ITP), and pure red cell aplasia (PRCA), in patients with solid tumors. In parallel, we report three illustrative cases from our institution to highlight diagnostic pitfalls and management strategies.</div></div><div><h3>Results</h3><div>The median onset of hematologic irAEs occurs after approximately 3 cycles of ICI therapy for AIHA and ITP, and after 4 cycles for PRCA. Most patients achieved remission with corticosteroid therapy; however, 10–15% were steroid-refractory or relapsed, requiring second-line immunosuppressive agents. Rechallenge with ICIs remains controversial due to a recurrence rate of irAE, although it may be feasible and clinically beneficial in carefully selected patients.</div></div><div><h3>Conclusion</h3><div>As the use of ICIs continues to rise, prompt recognition and management of hematologic irAEs are critical to minimize morbidity and to avoid premature discontinuation of immunotherapy. Increased clinician awareness and standardized diagnostic algorithms are essential to preserve both safety and efficacy.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"145 ","pages":"Article 103121"},"PeriodicalIF":10.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarker-guided immunotherapy in gastric cancer: current insights and future perspectives","authors":"Mar Teixidó Mulet ,&nbsp;Joel Veas Rodriguez ,&nbsp;Eduardo Terán ,&nbsp;Miquel Piñol ,&nbsp;Felip Vilardell ,&nbsp;Mar Iglesias ,&nbsp;Cinta Hierro ,&nbsp;Mariona Calvo ,&nbsp;Xavier Matias-Guiu ,&nbsp;Antonieta Salud ,&nbsp;Josep Tabernero ,&nbsp;Robert Montal","doi":"10.1016/j.ctrv.2026.103124","DOIUrl":"10.1016/j.ctrv.2026.103124","url":null,"abstract":"<div><div>Gastric and gastroesophageal junction adenocarcinoma (GC) is a biologically challenging malignancy associated with suboptimal clinical outcomes due to limited effective treatment options. The recent incorporation of immune checkpoint inhibitors (ICIs) into therapeutic algorithms has improved the clinical prospects of subsets of GC patients. However, responses to anti-PD-1/PD-L1 agents remain highly heterogeneous, with only some patients deriving long-term benefits. This variability highlights the importance of identifying optimal biomarkers to enhance patient selection, thereby enabling tailored immunotherapy strategies. Whereas microsatellite instability has demonstrated a potent capacity for predicting immunotherapy benefits in GC, other predictive biomarkers, such as PD-L1 expression, remain suboptimal. Advances in gene expression and epigenetic profiling, liquid biopsy approaches, gut microbiome characterization, and artificial intelligence-driven multimodal algorithms applied to multi-omics or digital pathology are key drivers for the comprehensive characterization of the GC tumour microenvironment (TME), which could be used for better treatment selection. Similarly, elucidating the complex tumour-immune interplay with these technologies will be crucial for the success of novel immunotherapeutic approaches under clinical development, by evaluating alternative immune pathways alone or in combination with current actionable targets of GC. The current review aims to give an overview of the current immunotherapeutic landscape in GC, evaluate standard-of-care and emerging biomarkers of immunotherapy response, and discuss the translational potential of incorporating multi-omic and AI-derived biomarkers into biomarker-enriched clinical decision-making frameworks.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"145 ","pages":"Article 103124"},"PeriodicalIF":10.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interplay of clonal hematopoiesis and cancer: Clinical implications in oncology","authors":"M. Tanguay ,&nbsp;M. Tagliamento ,&nbsp;J. Samaniego ,&nbsp;B. Besse ,&nbsp;A. Renneville ,&nbsp;E. Bernard ,&nbsp;J.-B. Micol","doi":"10.1016/j.ctrv.2026.103109","DOIUrl":"10.1016/j.ctrv.2026.103109","url":null,"abstract":"<div><div>Clonal hematopoiesis (CH) refers to the expansion of hematopoietic stem and progenitor cells carrying somatic mutations and is increasingly identified in oncology through cell-free DNA testing. Once regarded mostly as a precursor to myeloid neoplasms and a contributor to cardiovascular disease, CH is now recognized as a major determinant of clinical outcomes in patients with cancer. Specific anticancer agents selectively promote the expansion of clones with DNA damage response gene mutations, particularly those with <em>TP53</em> or <em>PPM1D</em> mutations, which are strongly associated with myeloid neoplasms post cytotoxic therapy (MN-pCT). The extent of clonal growth varies with treatment and, in some cases, may regress once therapy is withdrawn. In addition to therapy-driven clonal selection, inflammatory stress accelerates clonal expansion, creating a self-reinforcing cycle that contributes to atherosclerosis and other inflammation-associated complications. In oncology, CH-derived immune cells can infiltrate the tumor microenvironment and remodel local immunity, influencing tumor growth and treatment response. This tissue-infiltrating form of CH, termed tumor-infiltrating CH, has been associated with inferior survival in some cancer cohorts. Together, these findings establish CH as both a clinical challenge and an opportunity in modern oncology. Dedicated CH clinics and molecular tumor boards are emerging to address its implications for risk stratification, treatment selection, and survivorship care. This review examines the biology and clinical impact of CH in oncology, including its mutational spectrum, clonal evolution, role in MN-pCT, effects on inflammation and the tumor microenvironment, and emerging strategies for risk assessment and patient management.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"145 ","pages":"Article 103109"},"PeriodicalIF":10.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoantigen-based dendritic cell vaccines in lung cancer: overcoming immunosuppressive barriers for durable antitumor immunity","authors":"Zhang Li ,&nbsp;Zhang Feiyue ,&nbsp;Huang Luyu ,&nbsp;Zhang Wenqiang ,&nbsp;Mahmoud Ismail ,&nbsp;Jens-C Rueckert","doi":"10.1016/j.ctrv.2026.103125","DOIUrl":"10.1016/j.ctrv.2026.103125","url":null,"abstract":"<div><div>Cancer immunotherapies developed based on mechanisms of tumour immune evasion represent a major breakthrough in the history of cancer treatment, capable of reversing T-cell exhaustion induced by tumours through immune checkpoint blockade. However, the predominant focus on T cells as central players in antitumour immunity may have led to the oversight of the crucial role played by dendritic cells (DCs), which are essential for activating and directing T cells against tumour cells. DCs comprise a diverse group of antigen-presenting cells that play an indispensable role in initiating and regulating both innate and adaptive immune responses. Strategies aimed at modulating DC function to enhance cancer immunotherapy are therefore of critical importance. Beyond the development of novel immune checkpoint inhibitors, neoantigen-based DC vaccines represent a promising approach for developing personalised precision immunotherapies. Here, we review the molecular mechanisms underlying DC immunosuppression within the lung tumour microenvironment, how tumour-infiltrating DCs influence immunity and tolerance in the cancer setting, the mechanisms by which tumour-specific neoantigens elicit immune responses, the identification of neoantigens, and recent clinical advances in neoantigen-targeted vaccines for lung cancer. We also discuss recent progress in DC vaccine-based cancer immunotherapies from both preclinical studies and clinical trials.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"145 ","pages":"Article 103125"},"PeriodicalIF":10.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase III placebo-controlled oncology trials in the last decade: evolution, methodological foundations, and clinical impact","authors":"Fausto Petrelli ,&nbsp;Lorenzo Dottorini ,&nbsp;Alberto Zambelli","doi":"10.1016/j.ctrv.2026.103110","DOIUrl":"10.1016/j.ctrv.2026.103110","url":null,"abstract":"<div><div>Over the past decade, placebo-controlled phase III trials have remained central to therapeutic development in oncology, despite the rapid expansion of effective systemic treatments. In modern practice, placebo rarely represents the absence of therapy; rather, it serves as a methodological tool that preserves blinding, isolates the incremental effect of investigational agents, and minimizes assessment bias. Between 2015 and 2025, placebo-controlled designs underpinned many landmark trials across solid tumors and hematologic malignancies. In add-on first-line studies, placebo combined with standard-of-care therapy enabled accurate attribution of benefit to immune checkpoint inhibitors and targeted agents, including CDK4/6 inhibitors in hormone receptor–positive breast cancer. In the adjuvant setting, where observation historically constituted standard management, placebo provided an ethically appropriate comparator, supporting practice-changing trials in resected lung cancer, melanoma, renal cell carcinoma, and early breast cancer. Maintenance strategies, particularly in ovarian cancer, pancreatic cancer with germline BRCA mutations, and acute myeloid leukemia, relied on placebo to reflect real-world surveillance and to validate prolonged disease control in molecularly selected populations. In refractory disease, placebo-controlled trials remained acceptable when no effective standard therapies existed, allowing the identification of new agents with survival benefit. Across these contexts, placebo use has been essential for reducing bias in time-to-event endpoints, validating surrogate measures, and ensuring regulatory rigor. Collectively, evidence from the last decade indicates that placebo-controlled trials have facilitated, rather than hindered, major advances in oncology and will continue to play a critical role as treatment strategies become increasingly complex and precision driven.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"144 ","pages":"Article 103110"},"PeriodicalIF":10.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147319213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and treatment of human epidermal growth factor receptor 2-positive metastatic colorectal cancer: a systematic literature review","authors":"Salvatore Siena ,&nbsp;Myriam Chalabi ,&nbsp;Rachel Goodwin ,&nbsp;Pia Osterlund ,&nbsp;Frédérique Penault-Llorca ,&nbsp;Andrea Sartore-Bianchi ,&nbsp;Naureen Starling ,&nbsp;Sebastian Stintzing ,&nbsp;Josep Tabernero","doi":"10.1016/j.ctrv.2026.103097","DOIUrl":"10.1016/j.ctrv.2026.103097","url":null,"abstract":"<div><div>Human epidermal growth factor receptor 2 (HER2)-targeted therapies have been investigated for therapeutic benefit in <em>RAS</em>/<em>BRAF</em> wild-type/HER2+ metastatic colorectal cancer (mCRC). Unlike HER2+ breast and gastric cancer, there are no regulatory criteria for determining HER2 overexpression in patients with mCRC. This systematic literature review describes unmet needs for patients with HER2+ mCRC in relation to testing and treatment, highlights the importance of early HER2 testing at mCRC diagnosis, and discusses the evolving treatment landscape. We utilised PubMed and EMBASE databases up to November 2023 to identify journal articles and published congress abstracts relating to the HER2+ disease and treatment landscape, HER2 testing in mCRC, and HER2-targeted treatments in mCRC. Many studies have demonstrated the utility of immunohistochemistry, <em>in situ</em> hybridisation, and next-generation sequencing (tissue- and circulating tumour DNA-based) for detecting HER2 overexpression/amplification in mCRC and have attempted to establish consolidated criteria like those used for breast and gastric cancer. The value of HER2-targeted treatments in patients with HER2+ mCRC has been evidenced by clinical trials and meta-analyses, with strong evidence from MOUNTAINEER and DESTINY-CRC01 which supports the use of tucatinib + trastuzumab or trastuzumab deruxtecan, respectively, among this patient population. However, real-world analyses have confirmed that patients with HER2+ mCRC are not routinely tested for HER2 overexpression. Strong evidence and clinical guidelines support the value of HER2-targeted treatment among patients with HER2+ mCRC. There is a need for increased awareness and earlier uptake of HER2 testing among patients with mCRC to broaden treatment options and optimise outcomes for this patient population.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"144 ","pages":"Article 103097"},"PeriodicalIF":10.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunotherapy with anti-PD-1 or PD-L1 in advanced ovarian cancer: A meta-analysis of randomized trials","authors":"Riccardo Vida ,&nbsp;Michele Bartoletti ,&nbsp;Marcella Montico ,&nbsp;Sandro Pignata ,&nbsp;Gustavo Baldassarre ,&nbsp;Antonino Ditto ,&nbsp;Giulia Zapelloni ,&nbsp;Monica Rizzetto ,&nbsp;Ludovica Lay ,&nbsp;Poletto Margherita ,&nbsp;Fabio Puglisi","doi":"10.1016/j.ctrv.2026.103094","DOIUrl":"10.1016/j.ctrv.2026.103094","url":null,"abstract":"<div><h3>Background</h3><div>Ovarian cancer remains the gynecological malignancy with the highest mortality rate. Despite advances in treatment, the median overall survival remains suboptimal. Although there is strong biological rationale for the use of immune checkpoint inhibitors (ICIs), their clinical efficacy in ovarian cancer remains uncertain. This study aimed to evaluate the effectiveness of anti–PD-1/PD-L1 agents in advanced ovarian cancer by reviewing randomized trials.</div></div><div><h3>Methods</h3><div>We performed a systematic review and <em>meta</em>-analysis of randomized controlled trials (RCTs). Data sources included PubMed, EMBASE, the Cochrane Library, and major conference abstracts, with searches conducted up to July 1, 2025. Eligible studies included RCTs comparing anti–PD-1/PD-L1 agents (with or without chemotherapy) to standard treatments in patients with advanced ovarian cancer (first-line, platinum-sensitive, or platinum-resistant). Trials with fewer than 50 patients or non-randomized designs were excluded. Two authors independently extracted summary-level data. The primary outcome measure was progression-free survival (PFS) in the intention-to-treat population. A random-effects model was used to estimate pooled hazard ratios (HRs). Risk of bias was assessed using the Cochrane RoB 2 tool. (Supplementary, Fig. S1) The <em>meta</em>-analysis was registered with PROSPERO (CRD420251112816).</div></div><div><h3>Findings</h3><div>Ten RCTs (n = 7,847 patients) met the inclusion criteria. Overall, ICIs did not significantly improve PFS compared to control treatments (HR 0.98, 95% CI 0.85–1.12; I² = 67%). No significant benefit was observed in either first-line (HR 0.93) or recurrent settings (HR 1.07), nor in PD-L1–positive, BRCA-mutated, or homologous recombination deficiency (HRD) populations. A non-significant trend favouring ICI + PARP inhibitor combinations was observed in HR-proficient patients (HR 0.77, 95% CI 0.65–0.92). Sensitivity analyses confirmed the robustness of the findings. Overall survival (OS) data were either immature or not reported in most trials. The risk of bias was rated as low to moderate across studies, although there was high heterogeneity.</div></div><div><h3>Interpretation:</h3><div>Anti–PD-1/PD-L1-based ICI strategies have not led to significant improvements in outcomes for ovarian cancer. Future studies should focus on optimizing biomarker selection, evaluating combination therapies, and targeting the tumor microenvironment to enhance the efficacy of immunotherapy.</div><div>Funding:</div><div>This research received no external funding.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"144 ","pages":"Article 103094"},"PeriodicalIF":10.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}