Effectiveness and Safety of Neoadjuvant Immunotherapy Combined with Chemotherapy in Resectable Non-Small Cell Lung Cancer: A Meta-Analysis

Abstract With the immunotherapy widely used in lung cancer, neoadjuvant immunotherapy has also been used in the resectable non-small cell lung cancer (NSCLC). However, the result of neoadjuvant immunotherapy was unsatisfied, and the improvement of prognosis in NSCLC was limited. In this essay, we tr...
Ausführliche Beschreibung

Abstract With the immunotherapy widely used in lung cancer, neoadjuvant immunotherapy has also been used in the resectable non-small cell lung cancer (NSCLC). However, the result of neoadjuvant immunotherapy was unsatisfied, and the improvement of prognosis in NSCLC was limited. In this essay, we tried to explore the effectiveness and safety of neoadjuvant chemoimmunotherapy, a new treatment schedule for NSCLC. This meta-analysis was enrolled in International Prospective Register of Systematic Reviews (PROSPERO), and the registration number was CRD42021249716. This meta-analysis assembled ten relevant articles in online databases reported before May 12, 2021, including PubMed, Embase, and Cochrane Library. Aiming to evaluate the effectiveness and safety of neoadjuvant chemoimmunotherapy, the perspective of odds ratio (OR), 95% confidence interval (CI), heterogeneity and subgroup analysis was calculated and reported in this meta-analysis. There were 293 patients in ten studies. The effectiveness of neoadjuvant chemoimmunotherapy was evaluated by major pathological response (MPR) and pathological complete response (pCR). The pooled odds ratio (OR) of MPR and pCR was 1.56 (95% CI, 1.15–2.11, P = 0.004) and 0.34 (95%CI, 0.21–0.56, P < 0.0001), which was significantly higher than neoadjuvant immunotherapy (MPR: OR = 0.59; 95%CI, 0.36–0.98, P = 0.04; pCR: OR = 0.16; 95% CI, 0.09–0.27, P < 0.00001). The incidence of surgical resection in neoadjuvant chemoimmunotherapy was 83.6%. The percentage of Grade ≥ 3 treatment-related adverse events (TRAEs) was 33.3%, giving unsatisfied results compared to 12.5% in the meta-analysis of neoadjuvant immunotherapy. Our results revealed the effectiveness and safety of neoadjuvant chemoimmunotherapy in locally advanced resectable NSCLC. Ausführliche Beschreibung