BMC cancer · 2026
Meta-analysis reveals pathological complete response benefits from neoadjuvant immuno-chemotherapy combination in patients with HER2-negative breast cancer.
СтатьяМетаанализНазвание и аннотация: Перевод в очереди
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Wei Yuhan, Qi Yalong, Ge Hewei, Zeng Cheng, Li Qin, Ma Fei
Аннотация
PURPOSE: This meta-analysis aims to evaluate the pooled pathological complete response (pCR) rate and the relative benefits across different subgroups in human epidermal growth factor receptor 2 (HER2) -negative breast cancer treated with immunotherapy.
METHODS: Clinical trials for neoadjuvant immunotherapy in combination with chemotherapy were identified. The pooled pCR rate of total population and patients across different subgroups was performed.
RESULTS: Totally, the meta-analysis included 15 clinical trials comprising 3,885 patients. The pooled pCR rate was 58% (95% CI, 54-62) for triple-negative breast cancer (TNBC) patients and 25% (95% CI, 22-27) for hormone receptor (HR)-positive/HER2-negative (HR+HER2-) patients, respectively. However, the relative benefit of neoadjuvant chemotherapy combined with immunotherapy compared to chemotherapy was comparable (p = 0.70), with odds ratio (OR) of 1.76 (95% CI, 1.43-2.17) in TNBC patients and 1.87 (95% CI, 1.49-2.36) in HR+HER2- patients. Subgroup analysis showed that programmed cell death ligand-1 (PD-L1)-positive patients had higher pCR benefits compared to PD-L1-negative patients, regardless of whether it was immunotherapy combined with neoadjuvant chemotherapy or neoadjuvant chemotherapy alone, with OR of 3.41 (2.61-4.45) and 2.48 (1.80-3.42) respectively. Conversely, among patients receiving chemotherapy alone, the pCR rate in lymph node-positive cases was 42% lower than that in lymph node-negative cases, while the addition of immunotherapy enabled lymph node-positive patients to achieve a comparable pCR rate to lymph node-negative patients (OR, 1.08).
CONCLUSION: Immunotherapy showed substantial benefits in improving pCR rates in both TNBC and HR+HER2- patients when combined with neoadjuvant chemotherapy, especially in lymph node-positive breast cancer patients.
METHODS: Clinical trials for neoadjuvant immunotherapy in combination with chemotherapy were identified. The pooled pCR rate of total population and patients across different subgroups was performed.
RESULTS: Totally, the meta-analysis included 15 clinical trials comprising 3,885 patients. The pooled pCR rate was 58% (95% CI, 54-62) for triple-negative breast cancer (TNBC) patients and 25% (95% CI, 22-27) for hormone receptor (HR)-positive/HER2-negative (HR+HER2-) patients, respectively. However, the relative benefit of neoadjuvant chemotherapy combined with immunotherapy compared to chemotherapy was comparable (p = 0.70), with odds ratio (OR) of 1.76 (95% CI, 1.43-2.17) in TNBC patients and 1.87 (95% CI, 1.49-2.36) in HR+HER2- patients. Subgroup analysis showed that programmed cell death ligand-1 (PD-L1)-positive patients had higher pCR benefits compared to PD-L1-negative patients, regardless of whether it was immunotherapy combined with neoadjuvant chemotherapy or neoadjuvant chemotherapy alone, with OR of 3.41 (2.61-4.45) and 2.48 (1.80-3.42) respectively. Conversely, among patients receiving chemotherapy alone, the pCR rate in lymph node-positive cases was 42% lower than that in lymph node-negative cases, while the addition of immunotherapy enabled lymph node-positive patients to achieve a comparable pCR rate to lymph node-negative patients (OR, 1.08).
CONCLUSION: Immunotherapy showed substantial benefits in improving pCR rates in both TNBC and HR+HER2- patients when combined with neoadjuvant chemotherapy, especially in lymph node-positive breast cancer patients.