ArticleTranslational lung cancer research2025
A systematic review and network meta-analysis of immune checkpoint inhibitors in operable NSCLC: neoadjuvant, adjuvant, or perioperative?
Article in Translational lung cancer research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association between immune checkpoint inhibitors and the risk and prognosis of uveitis: a meta-analysis.Frontiers in immunology · 2026Pooled it
- T-Cell Exhaustion in the Tumor Microenvironment: Subcellular Dysfunction, Pan-Cancer Characteristics, and Therapeutic Interventions.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The optimal timing for immune checkpoint inhibitor (ICI) therapy in patients with operable non-small cell lung cancer (NSCLC) remains a subject of clinical uncertainty. This Bayesian network meta-analysis (NMA) aimed to compare the efficacy of ICIs administered in neoadjuvant, adjuvant, and perioperative settings. Methods: A systematic review of randomized controlled trials (RCTs) published up to September 1, 2024, identified eight eligible studies comprising a total of 3,659 patients. Primary outcomes included disease-free survival (DFS) and event-free survival (EFS). A Bayesian framework was used to estimate hazard ratios (HRs) and 95% credible intervals (CrIs), with treatment efficacy ranked using the surface under the cumulative ranking curve (SUCRA). Risk of bias was assessed using the Cochrane Risk of Bias tool, and sensitivity analyses confirmed the robustness of the findings after exclusion of studies at higher risk. Results: Perioperative ICIs demonstrated superior efficacy compared with neoadjuvant or adjuvant strategies. Specifically, perioperative toripalimab plus chemotherapy ranked first (SUCRA =0.99; rank 1 probability =87%), followed by perioperative nivolumab (SUCRA =0.94). Both regimens significantly reduced the risk of disease recurrence or progression compared to surgery alone or standard chemotherapy. While neoadjuvant and adjuvant ICIs provided moderate benefit, they ranked lower in overall efficacy. Sensitivity analyses excluding higher-risk studies did not substantially alter the results, confirming their robustness. No direct comparisons were available between all strategies, and heterogeneity in control arms, ICI agents, programmed death ligand-1 (PD-L1) inclusion thresholds, and follow-up duration limit cross-trial comparability. Additionally, long-term overall survival data were largely immature across studies. Conclusions: These findings suggest that perioperative administration of ICIs, particularly toripalimab and nivolumab in combination with chemotherapy, may offer the most effective approach to improving DFS/EFS in resectable NSCLC. However, further head-to-head trials, longer follow-up, and biomarker-stratified analyses are needed to confirm these results and guide personalized treatment decisions.
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Registered trials
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.