SynthesisFrontiers in pharmacology2026
Immune checkpoint inhibitors across neoadjuvant, perioperative, and adjuvant settings for resectable non-small-cell lung cancer: a systematic review and meta-analysis of randomized trials.
Synthesis in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
4 authors.
Funding
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Abstract
Background: Randomized evidence for immune checkpoint inhibition in resectable non-small-cell lung cancer has progressed from pathological response to mature survival outcomes. We examined exploratory directional alignment across endpoints and quantified clinical yield, treatment burden, and the extent of perioperative therapy delivery. Methods: We synthesized 20 peer-reviewed reports from 12 parent randomized trials, including 8,197 unique participants and 13 eligible randomized treatment comparisons. The parent trial was the analysis unit, and the latest compatible report replaced earlier estimates for each time-to-event outcome. Direct randomized comparisons were pooled using restricted maximum-likelihood random-effects models. We reconstructed cumulative event-free survival (EFS) and overall survival (OS) evidence, estimated absolute differences, performed exploratory trial-level cross-endpoint analyses, and pooled the proportion of experimental-arm patients who started postoperative study treatment. Results: Across seven trials, treatment initiated before surgery reduced EFS events by 41% (HR, 0.59; 95% CI: 0.53-0.66; I Conclusion: ICI-containing strategies initiated before surgery improve pathological response, EFS, and OS in resectable NSCLC. Approximately 70% of patients assigned to perioperative experimental arms started postoperative study treatment; this descriptive treatment-delivery finding does not establish whether postoperative ICI can be safely omitted. Prospective response- and residual-risk-guided randomized trials are required.
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