Evidence map›Paper›PMID 40852484›Full record

SynthesisFrontiers in oncology2025

The efficacy and immune-mediated safety of PD-1/PD-L1 combined with neoadjuvant chemotherapy in triple-negative breast cancer: a meta-analysis.

Xiao Yan, Qi Lv, Jiangzhuo Wu, Jiang Fang, Lin Peng, Xiaobo Zhao

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Xiao Yan *Department of Thyroid and Breast Surgery/School of Clinical Medicine, North Sichuan Medical College/Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
Qi Lv *Department of Surgical Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
Jiangzhuo WuDepartment of Thyroid and Breast Surgery/School of Clinical Medicine, North Sichuan Medical College/Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
Jiang FangDepartment of Thyroid and Breast Surgery/School of Clinical Medicine, North Sichuan Medical College/Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
Lin PengDepartment of Thyroid and Breast Surgery/School of Clinical Medicine, North Sichuan Medical College/Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
Xiaobo ZhaoDepartment of Thyroid and Breast Surgery/School of Clinical Medicine, North Sichuan Medical College/Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The efficacy and immune-mediated safety of PD-1/PD-L1 inhibitors in triple-negative breast cancer (TNBC) remain controversial. Given TNBC's aggressive biology and poor prognosis, definitive evidence is urgently needed. We performed this meta-analysis to comprehensively assess the benefits and safety of these inhibitors by examining clinical trial data for TNBC. Methods: Up until October 25, 2024, a thorough search was done in the PubMed, Embase, and Cochrane databases to find research assessing PD-1/PD-L1 inhibitors in treating TNBC. This study ultimately included 8 randomized controlled trials involving 5,512 patients. Pathological complete response (pCR), progression-free survival (PFS), overall survival (OS), event-free survival (EFS), and immune-related adverse events (irAEs) were among the primary objectives, which defined as adverse drug reactions affecting various organ systems due to immune system activation, were graded according to CTCAE v5.0 criteria. Results: The combination of PD-1/PD-L1 inhibitors with neoadjuvant chemotherapy significantly increased pCR rates by 77% compared to chemotherapy alone (OR=1.77, 95% CI: 1.28-2.45, P<0.01). Subgroup analyses indicated that the benefit of pCR was more evident in patients with lymph node positivity(OR=2.57,95% CI:1.76-3.75, P < 0.01). For EFS, the integration of immune checkpoint inhibitors(ICIs) combination therapy decreased the possibility of events by 35% (HR=0.65,95%CI:0.54-0.80, P< 0.01), with notable benefits observed in earlier-stage (T1-T2) patients(HR= 0.53, 95%CI:0.40-0.70, P < 0.01). Similarly, PFS was improved in the experimental group for both ITT (HR=0.79,95% CI, 0.71-0.88, P<0.01) and PD-L1 positive populations (HR=0.71,95%CI:0.63-0.81, P < 0.01). However, the incidence of irAEs was significantly higher in the ICIs group compared to the neoadjuvant chemotherapy group (OR=2.77,95% CI:1.93-3.96, P < 0.01). Conclusion: With lymph node status acting as a crucial predictor, the combination of PD-1/PD-L1 inhibitors and neoadjuvant chemotherapy dramatically improves pCR and EFS in TNBC. Additionally, it improves OS and PFS, although at the cost of an increased incidence of irAEs. These findings offer insightful information for upcoming clinical trial designs, economic evaluations, and clinical decision-making in TNBC treatment. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42025640551.

Indexed as

immune checkpoint inhibitorsmeta-analysisneoadjuvant chemotherapy; triple-negative breast cancerPD-1/PD-L1 inhibitorssystematic review

Identifiers

PMID40852484
PMCPMC12367678

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.