Neoadjuvant Chemoimmunotherapy in Resectable NSCLC With PD-L1 Expression < 1%: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials - PubMed
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- #Neoadjuvant Therapy
- #PD-L1 Expression
- #Randomized Controlled Trials
- Neoadjuvant chemoimmunotherapy does not show significant improvements in event-free or overall survival compared to chemotherapy alone in resectable NSCLC patients with PD-L1 expression < 1%.
- Among chemoimmunotherapy regimens, nivolumab plus chemotherapy is the only one significantly improving pathological complete response, with an odds ratio of 5.88 (95% credible interval 1.41-37.4).
- No chemoimmunotherapy regimens significantly improved major pathological response for patients with PD-L1 < 1%, though chemotherapy alone consistently ranked lowest across all outcomes.
- The systematic review and network meta-analysis included eight randomized controlled trials, comprising 1012 patients (29.9%) with PD-L1 < 1% out of 3387 total participants.
- Current evidence suggests chemoimmunotherapy enhances pathological response without confirmed survival benefits, supporting further research into optimal strategies for PD-L1 low-expressing NSCLC.