ArticleJournal of thoracic disease2026
Equivalence of neoadjuvant and perioperative therapies in patients with stage III non-small cell lung cancer: a systematic review and meta-analysis.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Both neoadjuvant and perioperative immunotherapies have emerged as standard-of-care treatments for patients with resectable non-small cell lung cancer (NSCLC). However, the optimal treatment strategy regarding the necessity of the adjuvant phase remains undefined due to a lack of direct head-to-head comparisons. This study thus aimed to quantitatively evaluate whether extending immunotherapy into the adjuvant phase confers a survival benefit over neoadjuvant therapy alone in patients with stage III NSCLC. Methods: A systematic search of the PubMed, Embase, Cochrane Library, and Web of Science databases was conducted for randomized controlled trials (RCTs) published as of June 21, 2025. Individual patient data (IPD) were reconstructed from Kaplan-Meier (KM) curves of the eligible studies. The primary end points were event-free survival (EFS) and overall survival (OS). Statistical analyses included stratified log-rank tests, Cox proportional hazards regression, and restricted mean survival time (RMST) analysis. Results: Seven studies (six RCTs and one single-arm phase II trial) involving 1,436 patients with stage III NSCLC were included in the analysis. In the overall population, neoadjuvant and perioperative immunotherapies demonstrated comparable efficacy, with no significant difference in EFS [hazard ratio (HR) =0.99; 95% confidence interval (CI): 0.72-1.36; P=0.94]. Subgroup analysis indicated stage-dependent outcomes: EFS was similar in the stage IIIA cohort (HR =1.04; P=0.87), whereas a nonsignificant advantage for neoadjuvant therapy was observed in the mixed-stage IIIA-IIIB cohort (HR =0.52; 95% CI: 0.27-1.03; P=0.05). In the analysis of OS, which was restricted to the stage IIIA population due to data maturity, no significant difference was found between the two strategies (HR =0.97; 95% CI: 0.58-1.64; P=0.92). The 5-year RMST of OS was 48.51 months for the neoadjuvant group and 47.56 months for the perioperative group (difference =0.95 months; P=0.69). Conclusions: The findings from this IPD-based quantitative analysis suggest that neoadjuvant immunotherapy may yield EFS and OS outcomes comparable to those of perioperative immunotherapy in patients with resectable stage III NSCLC. However, given the indirect nature of the comparison, these results should be considered hypothesis-generating; they provide a rationale for investigating a neoadjuvant-only strategy as a potential de-escalation approach. Future head-to-head trials are warranted to validate these findings, particularly among patients with stage IIIB disease.
Indexed as
Identifiers
What OpenQuestion holds
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.