Prognosis prediction using significant pathological response following neoadjuvant immunotherapy in resectable non-small-cell lung tumors: a meta-analysis

Abstract

Background: A meta-analysis study was done to figure out how to predict the prognosis of people with resectable non-small-cell lung cancer (NSCLC) who had a significant pathological response following neoadjuvant immunotherapy.

Methods: Up until August 2024, a comprehensive literature study was completed, and 2,386 connected studies were revised. The 35 selected studies included 3,118 resectable non-small-cell lung tumor participants at the beginning of the study. Using dichotomous techniques and a fixed or random model, the odds ratio (OR) and 95% confidence intervals (CIs) were used to assess the prediction using significant pathological response following neoadjuvant immunotherapy in resectable NSCLC.

Results: Individuals with resectable NSCLC had significantly higher major pathological response when comparing neoadjuvant chemo-immunotherapy to neoadjuvant chemotherapy (OR, 5.07; 95% CI, 4.09-6.27, p < 0.001), objective response rate to non-objective response rate (OR, 7.02; 95% CI, 4.28-11.50, p < 0.001), and programmed death-ligand 1 ≥1% to programmed death-ligand ≤1% (OR, 2.49; 95% CI, 1.44-4.30, p = 0.001). However, no significant difference was found in major pathological response between stage III and stage I-II (OR, 1.43; 95% CI, 0.88-2.33, p = 0.15), and squamous cell cancer and non-squamous cell cancer (OR, 1.35; 95% CI, 0.95-1.92, p = 0.09) in individuals with resectable NSCLCs.

Conclusion: Individuals with resectable NSCLCs had significantly higher major pathological response when comparing neoadjuvant chemo-immunotherapy to neoadjuvant chemotherapy, objective response rate to non-objective response rate, and programmed death-ligand 1≥1% to programmed death-ligand 1 ≤1%, however, no significant difference was found between stage III and stage I-II, and squamous cell cancer and non-squamous cell cancer. To validate this discovery, more research is required since most of the selected studies had a low sample size, and caution must be implemented when interacting with its values.

Keywords: neoadjuvant immunotherapy; pathological response; prognosis prediction; programmed death-ligand 1; resectable non-small-cell lung tumors; stage.