Systematic review and meta-analysis of neoadjuvant immune checkpoint inhibitors plus chemotherapy in early breast cancer

Recent studies have investigated the combination of immune checkpoint inhibitors (ICIs) with neoadjuvant or adjuvant chemotherapy in early-stage breast cancer. However, there is an ongoing debate about the optimal approach for integrating this strategy. Systematic review and meta-analysis of nine randomized controlled trials involving 5114 patients found that neoadjuvant ICI therapy was associated with improved efficacy outcomes in early-stage triple negative breast cancer and PD-L1-positive hormone receptor-positive/ HER2-negative tumors with an acceptable safety profile. However, in triple-negative breast cancer, no benefit was observed with adjuvant ICI in patients with pathologic complete respons or residual disease. The authors conclude that these results favor neoadjuvant over adjuvant ICI therapy in the treatment of early-stage breast cancer.