{"title":"IB期非小细胞肺癌的辅助治疗：替加福-尿嘧啶和免疫检查点抑制剂的网络荟萃分析","authors":"Masatsugu Hamaji, Jiro Takeuchi, Naoki Ozu, Ryo Miyata, Keiji Yamanashi, Takeshi Kawaguchi, Mitsuharu Hosono","doi":"10.1053/j.semtcvs.2025.03.011","DOIUrl":null,"url":null,"abstract":"<p><p>Recent clinical trials demonstrated that as adjuvant therapy, immune checkpoint inhibitors (ICIs) following intravenous cytotoxic chemotherapy may have a nonsignificant advantage over intravenous cytotoxic chemotherapy only in completely resected stage IB non-small cell lung cancer (NSCLC). Meanwhile, several studies reported that oral tegafur-uracil may have a comparable benefit to intravenous chemotherapy in long-term survival outcomes in these patients. However, there is currently a lack of head-to-head comparison between ICIs following intravenous cytotoxic chemotherapy and tegafur-uracil. Therefore, we designed a network meta-analysis in assessing overall survival (OS) and a composite endpoint of disease free survival (DFS) and recurrence free survival (RFS) as measures of effect. Our results indicated that, limited to stage IB, calculated hazard ratio (HR) was 1.02 (95% confidence interval [CI]: 0.53-1.96) for OS and calculated HR was 0.90 (95% CI: 0.43-1.87) for DFS, while in stage IB to IIIA patients, calculated HR was 0.97 (95% CI: 0.70-1.37) for OS and calculated HR was 0.75 (95% CI: 0.59-0.95) for DFS. In conclusion, tegafur-uracil may offer a comparable benefit to ICIs following chemotherapy in limitation to stage IB NSCLC patients only. Future clinical trials may be designed for stage IB NSCLC, separately from stage II and III.</p>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Adjuvant Therapy in Stage IB Non-Small Cell Lung Cancer: A Network Meta-Analysis of Tegafur-Uracil and Immune Checkpoint Inhibitors.\",\"authors\":\"Masatsugu Hamaji, Jiro Takeuchi, Naoki Ozu, Ryo Miyata, Keiji Yamanashi, Takeshi Kawaguchi, Mitsuharu Hosono\",\"doi\":\"10.1053/j.semtcvs.2025.03.011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Recent clinical trials demonstrated that as adjuvant therapy, immune checkpoint inhibitors (ICIs) following intravenous cytotoxic chemotherapy may have a nonsignificant advantage over intravenous cytotoxic chemotherapy only in completely resected stage IB non-small cell lung cancer (NSCLC). Meanwhile, several studies reported that oral tegafur-uracil may have a comparable benefit to intravenous chemotherapy in long-term survival outcomes in these patients. However, there is currently a lack of head-to-head comparison between ICIs following intravenous cytotoxic chemotherapy and tegafur-uracil. Therefore, we designed a network meta-analysis in assessing overall survival (OS) and a composite endpoint of disease free survival (DFS) and recurrence free survival (RFS) as measures of effect. Our results indicated that, limited to stage IB, calculated hazard ratio (HR) was 1.02 (95% confidence interval [CI]: 0.53-1.96) for OS and calculated HR was 0.90 (95% CI: 0.43-1.87) for DFS, while in stage IB to IIIA patients, calculated HR was 0.97 (95% CI: 0.70-1.37) for OS and calculated HR was 0.75 (95% CI: 0.59-0.95) for DFS. In conclusion, tegafur-uracil may offer a comparable benefit to ICIs following chemotherapy in limitation to stage IB NSCLC patients only. Future clinical trials may be designed for stage IB NSCLC, separately from stage II and III.</p>\",\"PeriodicalId\":48592,\"journal\":{\"name\":\"Seminars in Thoracic and Cardiovascular Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-04-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Seminars in Thoracic and Cardiovascular Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1053/j.semtcvs.2025.03.011\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in Thoracic and Cardiovascular Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1053/j.semtcvs.2025.03.011","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Adjuvant Therapy in Stage IB Non-Small Cell Lung Cancer: A Network Meta-Analysis of Tegafur-Uracil and Immune Checkpoint Inhibitors.
Recent clinical trials demonstrated that as adjuvant therapy, immune checkpoint inhibitors (ICIs) following intravenous cytotoxic chemotherapy may have a nonsignificant advantage over intravenous cytotoxic chemotherapy only in completely resected stage IB non-small cell lung cancer (NSCLC). Meanwhile, several studies reported that oral tegafur-uracil may have a comparable benefit to intravenous chemotherapy in long-term survival outcomes in these patients. However, there is currently a lack of head-to-head comparison between ICIs following intravenous cytotoxic chemotherapy and tegafur-uracil. Therefore, we designed a network meta-analysis in assessing overall survival (OS) and a composite endpoint of disease free survival (DFS) and recurrence free survival (RFS) as measures of effect. Our results indicated that, limited to stage IB, calculated hazard ratio (HR) was 1.02 (95% confidence interval [CI]: 0.53-1.96) for OS and calculated HR was 0.90 (95% CI: 0.43-1.87) for DFS, while in stage IB to IIIA patients, calculated HR was 0.97 (95% CI: 0.70-1.37) for OS and calculated HR was 0.75 (95% CI: 0.59-0.95) for DFS. In conclusion, tegafur-uracil may offer a comparable benefit to ICIs following chemotherapy in limitation to stage IB NSCLC patients only. Future clinical trials may be designed for stage IB NSCLC, separately from stage II and III.
期刊介绍：
Seminars in Thoracic and Cardiovascular Surgery is devoted to providing a forum for cardiothoracic surgeons to disseminate and discuss important new information and to gain insight into unresolved areas of question in the specialty. Each issue presents readers with a selection of original peer-reviewed articles accompanied by editorial commentary from specialists in the field. In addition, readers are offered valuable invited articles: State of Views editorials and Current Readings highlighting the latest contributions on central or controversial issues. Another prized feature is expert roundtable discussions in which experts debate critical questions for cardiothoracic treatment and care. Seminars is an invitation-only publication that receives original submissions transferred ONLY from its sister publication, The Journal of Thoracic and Cardiovascular Surgery. As we continue to expand the reach of the Journal, we will explore the possibility of accepting unsolicited manuscripts in the future.
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