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Purpose <p>This meta-analysis evaluated the efficacy of adjuvant ICIs in resected stage IB–IIIA NSCLC following chemotherapy.</p> Methods <p>We searched Embase, Cochrane, PubMed, and major oncology conferences for randomized controlled trials (RCTs) comparing adjuvant ICIs with placebo/best supportive care. Outcomes included disease-free survival (DFS), overall survival (OS), and safety. Hazard ratios (HR) and risk ratios (RR) with 95% confidence intervals (CI) were calculated.</p> Results <p>Three RCTs (3401 patients) were analyzed. Adjuvant ICIs improved DFS (HR 0.85; <i>p</i> &lt; 0.01) but not OS (HR 0.93; <i>p</i> = 0.43). DFS benefits were observed in subgroups of patients who received prior chemotherapy (HR 0.83), had non-squamous histology (HR 0.75), or had PD-L1 expression of 1–49% (HR 0.82). ICIs increased grade 3–4 (RR 1.42) and grade 5 adverse events (RR 2.33).</p> Conclusion <p>This analysis supports the use of adjuvant ICIs in early-stage NSCLC, particularly in patients with non-squamous histology who have received prior adjuvant chemotherapy.</p>

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Adjuvant immune checkpoint inhibitors in early-stage non-small cell lung cancer: insights from a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年10月28日

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  • Isadora Mamede,
  • Carlos Stecca,
  • Gabriela Gazzoni,
  • Ana Caroline Fonseca Alves,
  • Fernanda Ronchi,
  • Vinicius Ernani

摘要

Purpose

This meta-analysis evaluated the efficacy of adjuvant ICIs in resected stage IB–IIIA NSCLC following chemotherapy.

Methods

We searched Embase, Cochrane, PubMed, and major oncology conferences for randomized controlled trials (RCTs) comparing adjuvant ICIs with placebo/best supportive care. Outcomes included disease-free survival (DFS), overall survival (OS), and safety. Hazard ratios (HR) and risk ratios (RR) with 95% confidence intervals (CI) were calculated.

Results

Three RCTs (3401 patients) were analyzed. Adjuvant ICIs improved DFS (HR 0.85; p < 0.01) but not OS (HR 0.93; p = 0.43). DFS benefits were observed in subgroups of patients who received prior chemotherapy (HR 0.83), had non-squamous histology (HR 0.75), or had PD-L1 expression of 1–49% (HR 0.82). ICIs increased grade 3–4 (RR 1.42) and grade 5 adverse events (RR 2.33).

Conclusion

This analysis supports the use of adjuvant ICIs in early-stage NSCLC, particularly in patients with non-squamous histology who have received prior adjuvant chemotherapy.