Sex Differences in the Efficacy of Immune Checkpoint Inhibitors in Neoadjuvant Therapy of Non-Small Cell Lung Cancer: A Meta-Analysis
Non-small cell lung cancer (NSCLC) is one of the world’s leading causes of morbidity and mortality. ICIs alone or combined with chemotherapy have become the standard first-line treatment of metastatic NSCLC. The impressive results obtained have stimulated our interest in applying these therapies in...
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MDPI AG
2023-09-01
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Online Access: | https://www.mdpi.com/2072-6694/15/18/4433 |
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author | Guillermo Suay Juan-Carlos Garcia-Cañaveras Francisco Aparisi Agustin Lahoz Oscar Juan-Vidal |
author_facet | Guillermo Suay Juan-Carlos Garcia-Cañaveras Francisco Aparisi Agustin Lahoz Oscar Juan-Vidal |
author_sort | Guillermo Suay |
collection | DOAJ |
description | Non-small cell lung cancer (NSCLC) is one of the world’s leading causes of morbidity and mortality. ICIs alone or combined with chemotherapy have become the standard first-line treatment of metastatic NSCLC. The impressive results obtained have stimulated our interest in applying these therapies in early disease stage treatments, as neoadjuvant immunotherapy has shown promising results. Among many of the factors that may influence responses, the role played by sex is attracting increased interest and needs to be addressed. Here, we aim to first review the state of the art regarding neoadjuvant ICIs, whether they are administered in monotherapy or in combination with chemotherapy at stages IB-IIIA, particularly at stage IIIA, before analyzing whether sex may influence responses. To this end, a meta-analysis of publicly available data comparing male and female major pathological responses (MPR) and pathological complete responses (pCR) was performed. In our meta-analysis, MPR was found to be significantly higher in females than in males, with an odds ratio (OR) of 1.82 (95% CI 1.13–2.93; <i>p</i> = 0.01), while pCR showed a trend to be more favorable in females than in males, but the OR of 1.62 was not statistically significant (95% CI 0.97–2.75; <i>p</i> = 0.08). Overall, our results showed that sex should be systematically considered in future clinical trials settings in order to establish the optimal treatment sequence. |
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institution | Directory Open Access Journal |
issn | 2072-6694 |
language | English |
last_indexed | 2024-03-10T22:57:02Z |
publishDate | 2023-09-01 |
publisher | MDPI AG |
record_format | Article |
series | Cancers |
spelling | doaj.art-345a4c159a174dad988b473699e066ad2023-11-19T09:53:46ZengMDPI AGCancers2072-66942023-09-011518443310.3390/cancers15184433Sex Differences in the Efficacy of Immune Checkpoint Inhibitors in Neoadjuvant Therapy of Non-Small Cell Lung Cancer: A Meta-AnalysisGuillermo Suay0Juan-Carlos Garcia-Cañaveras1Francisco Aparisi2Agustin Lahoz3Oscar Juan-Vidal4Biomarkers and Precision Medicine Unit, Health Research Institute La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, SpainBiomarkers and Precision Medicine Unit, Health Research Institute La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, SpainBiomarkers and Precision Medicine Unit, Health Research Institute La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, SpainBiomarkers and Precision Medicine Unit, Health Research Institute La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, SpainMedical Oncology Department, La Fe University and Polytechnic Hospital, Av. Fernando Abril Martorell, 106, 46026 Valencia, SpainNon-small cell lung cancer (NSCLC) is one of the world’s leading causes of morbidity and mortality. ICIs alone or combined with chemotherapy have become the standard first-line treatment of metastatic NSCLC. The impressive results obtained have stimulated our interest in applying these therapies in early disease stage treatments, as neoadjuvant immunotherapy has shown promising results. Among many of the factors that may influence responses, the role played by sex is attracting increased interest and needs to be addressed. Here, we aim to first review the state of the art regarding neoadjuvant ICIs, whether they are administered in monotherapy or in combination with chemotherapy at stages IB-IIIA, particularly at stage IIIA, before analyzing whether sex may influence responses. To this end, a meta-analysis of publicly available data comparing male and female major pathological responses (MPR) and pathological complete responses (pCR) was performed. In our meta-analysis, MPR was found to be significantly higher in females than in males, with an odds ratio (OR) of 1.82 (95% CI 1.13–2.93; <i>p</i> = 0.01), while pCR showed a trend to be more favorable in females than in males, but the OR of 1.62 was not statistically significant (95% CI 0.97–2.75; <i>p</i> = 0.08). Overall, our results showed that sex should be systematically considered in future clinical trials settings in order to establish the optimal treatment sequence.https://www.mdpi.com/2072-6694/15/18/4433immune checkpoint inhibitorsNSCLCneoadjuvancesexPD-L1immune system |
spellingShingle | Guillermo Suay Juan-Carlos Garcia-Cañaveras Francisco Aparisi Agustin Lahoz Oscar Juan-Vidal Sex Differences in the Efficacy of Immune Checkpoint Inhibitors in Neoadjuvant Therapy of Non-Small Cell Lung Cancer: A Meta-Analysis Cancers immune checkpoint inhibitors NSCLC neoadjuvance sex PD-L1 immune system |
title | Sex Differences in the Efficacy of Immune Checkpoint Inhibitors in Neoadjuvant Therapy of Non-Small Cell Lung Cancer: A Meta-Analysis |
title_full | Sex Differences in the Efficacy of Immune Checkpoint Inhibitors in Neoadjuvant Therapy of Non-Small Cell Lung Cancer: A Meta-Analysis |
title_fullStr | Sex Differences in the Efficacy of Immune Checkpoint Inhibitors in Neoadjuvant Therapy of Non-Small Cell Lung Cancer: A Meta-Analysis |
title_full_unstemmed | Sex Differences in the Efficacy of Immune Checkpoint Inhibitors in Neoadjuvant Therapy of Non-Small Cell Lung Cancer: A Meta-Analysis |
title_short | Sex Differences in the Efficacy of Immune Checkpoint Inhibitors in Neoadjuvant Therapy of Non-Small Cell Lung Cancer: A Meta-Analysis |
title_sort | sex differences in the efficacy of immune checkpoint inhibitors in neoadjuvant therapy of non small cell lung cancer a meta analysis |
topic | immune checkpoint inhibitors NSCLC neoadjuvance sex PD-L1 immune system |
url | https://www.mdpi.com/2072-6694/15/18/4433 |
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