可切除的非小细胞肺肿瘤新辅助免疫治疗后显著病理反应预测预后：一项荟萃分析。

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2024-11-22 eCollection Date: 2024-01-01 DOI:10.3389/fsurg.2024.1500593

Fang Nie, Ying Wang, Wanting Shi, Liru Zhu, Jing Hao, Rancen Tao

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引用次数: 0

摘要

背景：一项荟萃分析研究旨在研究如何预测可切除的非小细胞肺癌（NSCLC）患者在新辅助免疫治疗后有显著病理反应的预后。方法：截至2024年8月，完成综合文献研究，修改相关研究2386篇。35项选定的研究在研究开始时包括3,118名可切除的非小细胞肺肿瘤参与者。采用二分法和固定或随机模型，比值比（or）和95%置信区间（CIs）用于评估可切除NSCLC新辅助免疫治疗后显著病理反应的预测。结果：与新辅助化疗免疫治疗相比，可切除的NSCLC患者的主要病理反应明显高于新辅助化疗(OR, 5.07；95% CI, 4.09-6.27, p p p = 0.001)。然而，III期和I-II期的主要病理反应没有显著差异(OR, 1.43；95% CI, 0.88-2.33, p = 0.15)，鳞状细胞癌和非鳞状细胞癌(OR, 1.35；95% CI, 0.95-1.92, p = 0.09)。结论：可切除nsclc患者在新辅助化疗免疫治疗与新辅助化疗、客观缓解率与非客观缓解率、程序性死亡配体1≥1%与程序性死亡配体1≤1%之间的主要病理反应明显高于可切除nsclc患者，但在III期与I-II期、鳞状细胞癌与非鳞状细胞癌之间无显著差异。为了验证这一发现，需要进行更多的研究，因为大多数选定的研究样本量都很低，并且在与其值相互作用时必须谨慎。

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Prognosis prediction using significant pathological response following neoadjuvant immunotherapy in resectable non-small-cell lung tumors: a meta-analysis.

Background: A meta-analysis study was done to figure out how to predict the prognosis of people with resectable non-small-cell lung cancer (NSCLC) who had a significant pathological response following neoadjuvant immunotherapy.

Methods: Up until August 2024, a comprehensive literature study was completed, and 2,386 connected studies were revised. The 35 selected studies included 3,118 resectable non-small-cell lung tumor participants at the beginning of the study. Using dichotomous techniques and a fixed or random model, the odds ratio (OR) and 95% confidence intervals (CIs) were used to assess the prediction using significant pathological response following neoadjuvant immunotherapy in resectable NSCLC.

Results: Individuals with resectable NSCLC had significantly higher major pathological response when comparing neoadjuvant chemo-immunotherapy to neoadjuvant chemotherapy (OR, 5.07; 95% CI, 4.09-6.27, p < 0.001), objective response rate to non-objective response rate (OR, 7.02; 95% CI, 4.28-11.50, p < 0.001), and programmed death-ligand 1 ≥1% to programmed death-ligand ≤1% (OR, 2.49; 95% CI, 1.44-4.30, p = 0.001). However, no significant difference was found in major pathological response between stage III and stage I-II (OR, 1.43; 95% CI, 0.88-2.33, p = 0.15), and squamous cell cancer and non-squamous cell cancer (OR, 1.35; 95% CI, 0.95-1.92, p = 0.09) in individuals with resectable NSCLCs.

Conclusion: Individuals with resectable NSCLCs had significantly higher major pathological response when comparing neoadjuvant chemo-immunotherapy to neoadjuvant chemotherapy, objective response rate to non-objective response rate, and programmed death-ligand 1≥1% to programmed death-ligand 1 ≤1%, however, no significant difference was found between stage III and stage I-II, and squamous cell cancer and non-squamous cell cancer. To validate this discovery, more research is required since most of the selected studies had a low sample size, and caution must be implemented when interacting with its values.

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.