Immune checkpoint inhibitors combined with neoadjuvant chemotherapy and adjuvant chemotherapy in the treatment of early-stage triple-negative breast cancer：a meta-analysis
- VernacularTitle:ICIs联合新辅助及辅助化疗用于早期三阴性乳腺癌的Meta分析
- Author:
Chunyan YANG
1
;
Shaohua ZHANG
2
;
Rongkang LI
3
;
Lei PENG
2
;
Li ZHAO
1
;
Jun BIE
1
Author Information
1. Dept. of Oncology，Nanchong Hospital Affiliated to Beijing Anzhen Hospital，Capital Medical University （Nanchong Central Hospital），Sichuan Nanchong 637000，China
2. Dept. of Urology，South China Hospital Affiliated to Shenzhen University，Guangdong Shenzhen 518000，China
3. Dept. of Urology，the Second Hospital of Lanzhou University，Lanzhou 730030，China
- Publication Type:Journal Article
- Keywords:
triple-negative breast cancer;
immune checkpoint inhibitors;
neoadjuvant chemotherapy;
adjuvant chemotherapy
- From:
China Pharmacy
2025;36(18):2322-2327
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To evaluate the efficacy and safety of immune checkpoint inhibitors combined with neoadjuvant chemotherapy and adjuvant chemotherapy in the treatment of early-stage triple-negative breast cancer （TNBC）. METHODS A systematic search was conducted in PubMed， Embase， Cochrane Library， CNKI， and Wanfang Data to collect randomized controlled trials （RCT） on the use of immune checkpoint inhibitors combined with neoadjuvant chemotherapy and adjuvant chemotherapy （experimental group） versus neoadjuvant chemotherapy and adjuvant chemotherapy （control group） in the treatment of TNBC. After literature screening， data extraction and literature quality evaluation， meta-analysis was performed using Stata 17.0. RESULTS A total of 5 RCT involving 1 498 patients were included. The meta-analysis results showed that the pathological complete response rate （pCR） [RR＝1.34， 95%CI （1.09， 1.63）， P＝0.03]， pCR in patients with positive programmed death-1 （PD-1） and its ligand （PD-L1） [RR＝1.33， 95%CI （1.16， 1.51）， P＝0.01]， pCR in patients with positive lymph nodes [RR＝ 1.56， 95%CI （1.27， 1.93）， P＝0.01]， the incidence of grade 3-4 adverse events （AEs） [RR＝1.07， 95%CI （1.01， 1.14）， P＝ 0.04]， the incidence of serious AEs [RR＝1.57， 95%CI （1.31， 1.87）， P＝0.03]， and the incidence of treatment discontinuation due to AEs [RR＝1.45， 95%CI （1.19， 1.76）， P＝0.01] were significantly higher in the experimental group than control group. There were no statistically significant difference in pCR in patients with negative PD-1/PD-L1[RR＝ E-mail：biejun23@126.com 1.26， 95%CI （0.98， 1.62）， P＝0.08] and pCR in patients with negative lymph nodes [RR＝1.14， 95%CI （0.97， 1.33）， P＝0.17] between the two groups. CONCLUSIONS Immune checkpoint inhibitors combined with neoadjuvant chemotherapy and adjuvant chemotherapy demonstrates significant efficacy in early-stage TNBC patients， with more pronounced benefits observed in those who are PD-1/PD-L1 positive and lymph node- positive. However， the incidence of AEs is relatively high.
