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. 2021 Mar 11;2(1):60-68.
doi: 10.1002/mco2.61. eCollection 2021 Mar.

Clinical benefit of neoadjuvant anti-PD-1/PD-L1 utilization among different tumors

Zhiyang Li  1   2 , Xin Wu  3 , Yanjie Zhao  1   2 , Yinan Xiao  1   4 , Yunuo Zhao  1   4 , Ting Zhang  1   2 , Hui Li  1   2 , Fushen Sha  5 , Yating Wang  6 , Lei Deng  7 , Xuelei Ma  1   4
Affiliations

Clinical benefit of neoadjuvant anti-PD-1/PD-L1 utilization among different tumors

Zhiyang Li et al. MedComm (2020). .

Abstract

PD-1/PD-L1 (programmed cell death-1 and programmed death-ligand 1) inhibitors utilization in neoadjuvant therapy has been assessed in tumors. This study focused on the clinical benefits of neoadjuvant anti-PD-1/PD-L1 therapy. A comprehensive search was conducted in electronic databases to identify eligible studies. Major response rate (MRR) and complete response rate (CRR) were pooled in this analysis to assess the efficacy of neoadjuvant anti-PD-1/PD-L1 utilization, all grades and high-grade adverse events (AEs) were pooled to evaluate its safety. Twenty studies were included in this meta-analysis, with 828 patients suffering from different tumors. The pooled CRR of triple-negative breast cancer was 0.569 (95% CI 0.514, 0.624, I 2 = 0%) and the pooled MRR of lung cancer was 0.471 (95% CI 0.267, 0.575, I 2 = 0%). The most frequent adverse event was fatigue (0.272 95% CI 0.171, 0.402, I 2 = 87%), and the most common high-grade adverse event was febrile neutropenia (0.084 95% CI 0.063, 0.112, I 2 = 85%). In conclusion, neoadjuvant anti-PD-1/PD-L1 therapy received satisfactory clinical results in these tumors included.

Keywords: PD‐1/PD‐L1 inhibitors; atezolizumab; lung cancer; neoadjuavant therapy; triple‐negative breast cancer.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

FIGURE 1
FIGURE 1
The process of the study identification. Twenty studies were included to evaluate the clinical benefits of neoadjuvant PD‐1/PD‐L1 inhibitors utilization in several tumors
FIGURE 2
FIGURE 2
The risk of bias. The allocation concealment and blinding of participants and personnel were not evaluated as low risk. The overall risk of bias was evaluated as low risk
FIGURE 3
FIGURE 3
The efficacy of neoadjuvant anti‐PD‐1/PD‐L1 therapy. (A) The complete pathologic response rate in triple‐negative breast cancer patients; the vertical line indicates the overall mean rate (0.569). (B) The complete pathologic response rate in urothelial carcinoma patients; the vertical line indicates the overall mean rate (0.320). (C) The complete pathologic response rate in lung cancer patients; the vertical line indicates the overall mean rate (0.200). (D) The complete pathologic response rate in melanoma patients; the vertical line indicates the overall mean rate (0.185). (E) The major pathological response rate in lung cancer patients; the vertical line indicates the overall mean rate (0.471). (F) The major pathological response rate in head and neck cancer patients; the vertical line indicates the overall mean rate (0.062)
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