Efficacy and Safety of PD-1/PD-L1 Inhibitors in Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis
Background: Compared with other subtypes, triple-negative breast cancer (TNBC) is more aggressive and has a lower survival rate with chemotherapy being the only acknowledged systemic treatment option. Recently, PD-1/PD-L1 (programmed cell death-1 and programmed death-ligand 1) inhibitors have demons...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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IMR Press
2023-09-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/CEOG/50/9/10.31083/j.ceog5009185 |
| _version_ | 1797664568631099392 |
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| author | Zhen-Yu Li Zhen Zhang Xiao-Zhong Cao Yun Feng Sha-Sha Ren |
| author_facet | Zhen-Yu Li Zhen Zhang Xiao-Zhong Cao Yun Feng Sha-Sha Ren |
| author_sort | Zhen-Yu Li |
| collection | DOAJ |
| description | Background: Compared with other subtypes, triple-negative breast cancer (TNBC) is more aggressive and has a lower survival rate with chemotherapy being the only acknowledged systemic treatment option. Recently, PD-1/PD-L1 (programmed cell death-1 and programmed death-ligand 1) inhibitors have demonstrated survival benefits in locally advanced or metastatic TNBC patients. However, the effects of PD-1/PD-L1 inhibitors in neoadjuvant chemotherapy remain controversial. Methods: Extensive literature searches were conducted in the PubMed, Embase and Cochrane databases. A pooled odds ratio (OR) with 95% confidence intervals (CI) was analyzed. Results: Seven randomized controlled trials (N = 1707) were included. PD-1/PD-L1 inhibitor chemotherapy group showed pathological complete response (pCR) benefit of 59.0% vs. 40.4% (OR 1.98, 95% CI 1.38–2.82, p < 0.001). Hematological adverse events were similar. There was no significant difference between the two groups in terms of anemia (OR 1.25, 95% CI 0.93–1.68, p = 0.14; I2 = 0%, p = 0.99) or neutropenia (OR 1.00, 95% CI 0.82–1.21, p = 0.96; I2 = 0%, p = 0.70). Conclusions: Adding PD-1/PD-L1 inhibitors to neoadjuvant chemotherapy can improve pCR rates in TNBC patients without increasing hematological toxicities. The data suggests that PD-1/PD-L1 inhibitors may be a viable option for patients with TNBC. |
| first_indexed | 2024-03-11T19:31:11Z |
| format | Article |
| id | doaj.art-d38632c1bfdc45ffa3f6139264a214f5 |
| institution | Directory Open Access Journal |
| issn | 0390-6663 |
| language | English |
| last_indexed | 2024-03-11T19:31:11Z |
| publishDate | 2023-09-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj.art-d38632c1bfdc45ffa3f6139264a214f52023-10-06T13:17:09ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-09-0150918510.31083/j.ceog5009185S0390-6663(23)02109-7Efficacy and Safety of PD-1/PD-L1 Inhibitors in Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer: A Systematic Review and Meta-AnalysisZhen-Yu Li0Zhen Zhang1Xiao-Zhong Cao2Yun Feng3Sha-Sha Ren4Department of Breast Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, 471000 Luoyang, Henan, ChinaDepartment of Breast Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, 471000 Luoyang, Henan, ChinaDepartment of Breast Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, 471000 Luoyang, Henan, ChinaDepartment of Breast Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, 471000 Luoyang, Henan, ChinaDepartment of Breast Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, 471000 Luoyang, Henan, ChinaBackground: Compared with other subtypes, triple-negative breast cancer (TNBC) is more aggressive and has a lower survival rate with chemotherapy being the only acknowledged systemic treatment option. Recently, PD-1/PD-L1 (programmed cell death-1 and programmed death-ligand 1) inhibitors have demonstrated survival benefits in locally advanced or metastatic TNBC patients. However, the effects of PD-1/PD-L1 inhibitors in neoadjuvant chemotherapy remain controversial. Methods: Extensive literature searches were conducted in the PubMed, Embase and Cochrane databases. A pooled odds ratio (OR) with 95% confidence intervals (CI) was analyzed. Results: Seven randomized controlled trials (N = 1707) were included. PD-1/PD-L1 inhibitor chemotherapy group showed pathological complete response (pCR) benefit of 59.0% vs. 40.4% (OR 1.98, 95% CI 1.38–2.82, p < 0.001). Hematological adverse events were similar. There was no significant difference between the two groups in terms of anemia (OR 1.25, 95% CI 0.93–1.68, p = 0.14; I2 = 0%, p = 0.99) or neutropenia (OR 1.00, 95% CI 0.82–1.21, p = 0.96; I2 = 0%, p = 0.70). Conclusions: Adding PD-1/PD-L1 inhibitors to neoadjuvant chemotherapy can improve pCR rates in TNBC patients without increasing hematological toxicities. The data suggests that PD-1/PD-L1 inhibitors may be a viable option for patients with TNBC.https://www.imrpress.com/journal/CEOG/50/9/10.31083/j.ceog5009185pd-1/pd-l1 inhibitorsneoadjuvant therapypathological complete remissiontriple negative breast cancer |
| spellingShingle | Zhen-Yu Li Zhen Zhang Xiao-Zhong Cao Yun Feng Sha-Sha Ren Efficacy and Safety of PD-1/PD-L1 Inhibitors in Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis Clinical and Experimental Obstetrics & Gynecology pd-1/pd-l1 inhibitors neoadjuvant therapy pathological complete remission triple negative breast cancer |
| title | Efficacy and Safety of PD-1/PD-L1 Inhibitors in Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis |
| title_full | Efficacy and Safety of PD-1/PD-L1 Inhibitors in Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis |
| title_fullStr | Efficacy and Safety of PD-1/PD-L1 Inhibitors in Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Efficacy and Safety of PD-1/PD-L1 Inhibitors in Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis |
| title_short | Efficacy and Safety of PD-1/PD-L1 Inhibitors in Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis |
| title_sort | efficacy and safety of pd 1 pd l1 inhibitors in neoadjuvant chemotherapy for triple negative breast cancer a systematic review and meta analysis |
| topic | pd-1/pd-l1 inhibitors neoadjuvant therapy pathological complete remission triple negative breast cancer |
| url | https://www.imrpress.com/journal/CEOG/50/9/10.31083/j.ceog5009185 |
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