Immunotherapy with anti-PD-1 or PD-L1 in advanced ovarian cancer: A meta-analysis of randomized trials - PubMed

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Immunotherapy with anti-PD-1 or PD-L1 in advanced ovarian cancer was evaluated through a meta-analysis of randomized trials.
Ovarian cancer has the highest mortality rate among gynecological malignancies, with suboptimal median overall survival despite treatment advances.
The study aimed to assess the effectiveness of anti-PD-1/PD-L1 agents in advanced ovarian cancer by reviewing randomized trials.
A systematic review and meta-analysis of 10 RCTs (n = 7,847 patients) was conducted, with data sourced from PubMed, EMBASE, the Cochrane Library, and major conference abstracts.
ICIs did not significantly improve progression-free survival (PFS) compared to control treatments (HR 0.98, 95% CI 0.85-1.12; I2 = 67%).
No significant benefit was observed in first-line or recurrent settings, nor in PD-L1-positive, BRCA-mutated, or HRD populations.
A non-significant trend favoring ICI + PARP inhibitor combinations was observed in HR-proficient patients (HR 0.77, 95% CI 0.65-0.92).
Overall survival (OS) data were immature or not reported in most trials, with low to moderate risk of bias but high heterogeneity.
The study concluded that anti-PD-1/PD-L1-based ICI strategies have not significantly improved outcomes in ovarian cancer.
Future research should focus on optimizing biomarker selection, evaluating combination therapies, and targeting the tumor microenvironment to enhance immunotherapy efficacy.

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