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PD‑1/PD‑L1 immune checkpoint inhibitors in neoadjuvant therapy for solid tumors (Review)
Quanying Tang1, Shikang Zhao1, Ning Zhou1
1Department of Lung Cancer Surgery, Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China.
Abstract:
A comprehensive search regarding programmed cell death protein 1 (PD‑1)/programmed death‑ligand 1 (PD‑L1) inhibitor monotherapy or combination therapy in neoadjuvant settings of 11 types of solid cancer was performed using the PubMed, Cochrane and Embase databases, and the abstracts of various conferences were screened. Data presented in 99 clinical trials indicated that preoperative treatment with PD‑1/PD‑L1 combined therapy, particularly immunotherapy plus chemotherapy, could achieve a higher objective response rate, a higher major pathologic response rate and a higher pathologic complete response rate, as well as a lower number of immune‑related adverse events compared with PD‑1/PD‑L1 monotherapy or dual immunotherapy. Although PD‑1/PD‑L1 inhibitor combination caused more treatment‑related adverse events (TRAEs) in patients, most of the TRAEs were acceptable and did not cause marked delays in operation. The data suggest that patients with pathological remission after neoadjuvant immunotherapy exhibit improved postoperative disease‑free survival compared with those without pathological remission. Further studies are still required to evaluate the long‑term survival benefit of neoadjuvant immunotherapy.
Insights
Neoadjuvant programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitor combination therapy, especially with chemotherapy, improves response rates in solid cancers. This approach shows promise for better outcomes, despite manageable side effects.
Area of Science:
- Oncology
- Immunotherapy
- Cancer Research
Background:
- Programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors are crucial in cancer treatment.
- Neoadjuvant therapy aims to improve surgical outcomes and reduce recurrence in solid tumors.
Purpose of the Study:
- To evaluate the efficacy and safety of neoadjuvant PD-1/PD-L1 inhibitor monotherapy versus combination therapy across 11 solid cancer types.
- To compare response rates, pathological remission, and adverse events between different neoadjuvant immunotherapy strategies.
Main Methods:
- A comprehensive literature search was conducted across PubMed, Cochrane, and Embase databases, including conference abstracts.
- Data from 99 clinical trials investigating neoadjuvant PD-1/PD-L1 inhibitors in solid cancers were analyzed.
Main Results:
- Neoadjuvant PD-1/PD-L1 combination therapy, particularly with chemotherapy, demonstrated superior objective response rates, major pathologic response rates, and pathologic complete response rates.
- While combination therapy led to more treatment-related adverse events (TRAEs), they were generally acceptable and did not significantly delay surgery.
- Neoadjuvant immunotherapy-induced pathological remission correlated with improved postoperative disease-free survival.
Conclusions:
- Neoadjuvant PD-1/PD-L1 inhibitor combinations, especially immunotherapy plus chemotherapy, offer enhanced efficacy in solid cancers compared to monotherapy or dual immunotherapy.
- Pathological remission following neoadjuvant immunotherapy is a significant predictor of improved disease-free survival.
- Further research is needed to ascertain the long-term survival benefits of neoadjuvant immunotherapy.
