PMID- 37247009
OWN - NLM
STAT- MEDLINE
DCOM- 20231023
LR  - 20231023
IS  - 1743-9159 (Electronic)
IS  - 1743-9191 (Print)
IS  - 1743-9159 (Linking)
VI  - 109
IP  - 9
DP  - 2023 Sep 1
TI  - Does major pathological response after neoadjuvant Immunotherapy in resectable 
      nonsmall-cell lung cancers predict prognosis? A systematic review and 
      meta-analysis.
PG  - 2794-2807
LID - 10.1097/JS9.0000000000000496 [doi]
AB  - OBJECTIVE: Overall survival is the gold-standard outcome measure for phase 3 
      trials, but the need for a long follow-up period can delay the translation of 
      potentially effective treatment to clinical practice. The validity of major 
      pathological response (MPR) as a surrogate of survival for non small cell lung 
      cancer (NSCLC) after neoadjuvant immunotherapy remains unclear. METHODS: 
      Eligibility was resectable stage I-III NSCLC and delivery of PD-1/PD-L1/CTLA-4 
      inhibitors prior to resection; other forms/modalities of neoadjuvant and/or 
      adjuvant therapies were allowed. Statistics utilized the Mantel-Haenszel 
      fixed-effect or random-effect model depending on the heterogeneity ( I2 ). 
      RESULTS: Fifty-three trials (seven randomized, 29 prospective nonrandomized, 17 
      retrospective) were identified. The pooled rate of MPR was 53.8%. Compared to 
      neoadjuvant chemotherapy, neoadjuvant chemo-immunotherapy achieved higher MPR (OR 
      6.19, 4.39-8.74, P <0.00001). MPR was associated with improved disease-free 
      survival/progression-free survival/event-free survival (HR 0.28, 0.10-0.79, P 
      =0.02) and overall survival (HR 0.80, 0.72-0.88, P <0.0001). Patients with stage 
      III (vs I/II) and PD-L1 >/=1% (vs <1%) more likely achieved MPR (OR 1.66,1.02-2.70, 
      P =0.04; OR 2.21,1.28-3.82, P =0.004). CONCLUSIONS: The findings of this 
      meta-analysis suggest that neoadjuvant chemo-immunotherapy achieved higher MPR in 
      NSCLC patients, and increased MPR might be associated with survival benefits 
      treated with neoadjuvant immunotherapy. It appears that the MPR may serve as a 
      surrogate endpoint of survival to evaluate neoadjuvant immunotherapy.
CI  - Copyright (c) 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Chen, Yujia
AU  - Chen Y
AD  - Department of Radiation Oncology, the Fourth Hospital of Hebei Medical 
      University, Hebei Clinical Research Center for Radiation Oncology.
FAU - Qin, Jianjun
AU  - Qin J
AD  - Department of Thoracic Surgery, National Cancer Center/National Clinical Research 
      Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking 
      Union Medical College, Beijing, China.
FAU - Wu, Yajing
AU  - Wu Y
AD  - Department of Radiation Oncology, the Fourth Hospital of Hebei Medical 
      University, Hebei Clinical Research Center for Radiation Oncology.
FAU - Lin, Qiang
AU  - Lin Q
AD  - Department of Oncology, North China Petroleum Bureau General Hospital, Hebei 
      Medical University, Renqiu.
FAU - Wang, Jianing
AU  - Wang J
AUID- ORCID: 0000-0002-9733-1433
AD  - Department of Radiation Oncology, the Fourth Hospital of Hebei Medical 
      University, Hebei Clinical Research Center for Radiation Oncology.
FAU - Zhang, Wei
AU  - Zhang W
AD  - Department of Radiation Oncology, the Fourth Hospital of Hebei Medical 
      University, Hebei Clinical Research Center for Radiation Oncology.
FAU - Liang, Fei
AU  - Liang F
AD  - Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai.
FAU - Hui, Zhouguang
AU  - Hui Z
AD  - Department of VIP Medical Services & Radiation Oncology.
FAU - Zhao, Min
AU  - Zhao M
AD  - Department of Oncology, the First Hospital of Hebei Medical University, 
      Shijiazhuang.
FAU - Wang, Jun
AU  - Wang J
AD  - Department of Radiation Oncology, the Fourth Hospital of Hebei Medical 
      University, Hebei Clinical Research Center for Radiation Oncology.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20230901
PL  - United States
TA  - Int J Surg
JT  - International journal of surgery (London, England)
JID - 101228232
RN  - 0 (B7-H1 Antigen)
SB  - IM
MH  - Humans
MH  - Neoadjuvant Therapy
MH  - B7-H1 Antigen
MH  - *Carcinoma, Non-Small-Cell Lung/drug therapy
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - *Lung Neoplasms/drug therapy
MH  - Prognosis
MH  - Immunotherapy
PMC - PMC10498860
COIS- The authors have no conflicts of interest. Sponsorships or competing interests 
      that may be relevant to content are disclosed at the end of this article
EDAT- 2023/05/29 13:04
MHDA- 2023/10/23 12:42
PMCR- 2023/09/13
CRDT- 2023/05/29 11:05
PHST- 2023/02/03 00:00 [received]
PHST- 2023/05/11 00:00 [accepted]
PHST- 2023/10/23 12:42 [medline]
PHST- 2023/05/29 13:04 [pubmed]
PHST- 2023/05/29 11:05 [entrez]
PHST- 2023/09/13 00:00 [pmc-release]
AID - 01279778-990000000-00398 [pii]
AID - IJS-D-23-00239 [pii]
AID - 10.1097/JS9.0000000000000496 [doi]
PST - epublish
SO  - Int J Surg. 2023 Sep 1;109(9):2794-2807. doi: 10.1097/JS9.0000000000000496.