IMR Press / CEOG / Volume 50 / Issue 9 / DOI: 10.31083/j.ceog5009185
Open Access Systematic Review
Efficacy and Safety of PD-1/PD-L1 Inhibitors in Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis
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1 Department of Breast Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, 471000 Luoyang, Henan, China
*Correspondence: (Zhen-Yu Li)
Clin. Exp. Obstet. Gynecol. 2023, 50(9), 185;
Submitted: 28 March 2023 | Revised: 2 May 2023 | Accepted: 10 May 2023 | Published: 19 September 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Compared with other subtypes, triple-negative breast cancer (TNBC) is more aggressive and has a lower survival rate with chemotherapy being the only acknowledged systemic treatment option. Recently, PD-1/PD-L1 (programmed cell death-1 and programmed death-ligand 1) inhibitors have demonstrated survival benefits in locally advanced or metastatic TNBC patients. However, the effects of PD-1/PD-L1 inhibitors in neoadjuvant chemotherapy remain controversial. Methods: Extensive literature searches were conducted in the PubMed, Embase and Cochrane databases. A pooled odds ratio (OR) with 95% confidence intervals (CI) was analyzed. Results: Seven randomized controlled trials (N = 1707) were included. PD-1/PD-L1 inhibitor chemotherapy group showed pathological complete response (pCR) benefit of 59.0% vs. 40.4% (OR 1.98, 95% CI 1.38–2.82, p < 0.001). Hematological adverse events were similar. There was no significant difference between the two groups in terms of anemia (OR 1.25, 95% CI 0.93–1.68, p = 0.14; I2 = 0%, p = 0.99) or neutropenia (OR 1.00, 95% CI 0.82–1.21, p = 0.96; I2 = 0%, p = 0.70). Conclusions: Adding PD-1/PD-L1 inhibitors to neoadjuvant chemotherapy can improve pCR rates in TNBC patients without increasing hematological toxicities. The data suggests that PD-1/PD-L1 inhibitors may be a viable option for patients with TNBC.

PD-1/PD-L1 inhibitors
neoadjuvant therapy
pathological complete remission
triple negative breast cancer
Fig. 1.
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