Neoadjuvant immune checkpoint inhibitors for muscle-invasive urothelial carcinoma: a systematic review and meta-analysis - PubMed
7 hours ago
- #Immune checkpoint inhibitors
- #Muscle-invasive urothelial carcinoma
- #Neoadjuvant therapy
- Muscle-invasive urothelial carcinoma (MIUC) accounts for one-quarter of cancers and has high morbidity and mortality.
- Cisplatin neoadjuvant chemotherapy plus radical cystectomy improves survival but some patients are ineligible due to renal dysfunction or comorbidities.
- Immune checkpoint inhibitors (ICIs), established in metastatic disease, are emerging as neoadjuvant options.
- A systematic review and meta-analysis of 11 studies (573 patients, 82.02% male) was conducted.
- Pooled pathologic complete response (pCR) rate was 35% (95% CI: 31%-39%).
- 2-year overall survival (OS) was 85%, recurrence-free survival (RFS) was 78%, and event-free survival (EFS) was 73%.
- Grade ≥3 adverse events: cardiovascular (3%), hematological (16%), and immune-related (5%).
- Neoadjuvant ICIs show favorable efficacy and acceptable safety, especially for cisplatin-ineligible patients.
- Randomized trials are needed to confirm long-term outcomes and establish their role in curative treatment.