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محدثه محمدزاده، فائزه ضیائی، مهرنگار موبد، فریماه فروغی بیوکی، نوشین باریک رو

Efficacy and Safety of Immune Checkpoint Inhibitor Combinations in Perioperative Patients with Non-Small Cell Lung Cancer Mohadese Mohamadzade1,2, Faezeh Ziyaei3,4, Mehrnegar Moobed5, Farimah Foroughi Biuki5, Nooshin Barikrow6* 1 Department of Microbiology, Faculty of Advanced Sciences and Technology, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran. 2 Department of Medical Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 3 Department of Genetics, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran. 4 Farhikhtegan Medical Convergence Sciences Research Center, Farhikhtegan Hospital Tehran Medical Sciences, Islamic Azad University, Tehran, Iran 5 Department of Microbial Biotechnology Islamic Azad University, Science and Research Branch Tehran, Iran 6 Department of Molecular and Cellular Sciences, Faculty of Advanced Sciences and Technology, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran. *Corresponding Author’s E-mail: (noushinbarikrou@gmail.com) Background: Numerous randomized controlled trials (RCTs) support the use of immune checkpoint inhibitors (ICIs) combined with chemotherapy in early-stage non-small cell lung cancer (NSCLC) for adjuvant, neoadjuvant, and "sandwich" settings. However, distinctions between neoadjuvant and sandwich approaches remain ambiguous. Perioperative trials combining ICIs and chemotherapy are proposed; nevertheless, a lack of direct comparisons in randomized controlled trials (RCTs) limits evidence for an optimal approach. This paper takes a systematic review approach towards assessing the efficacy and safety of different combinations of ICIs and chemotherapy for treating perioperative NSCLC. Methods: A comprehensive search was conducted in the major bibliographical databases PubMed, EMBASE, Cochrane Library, Web of Science, and major conference proceedings. Studies were screened, considering relevance, methodological quality, and study objectives. Eventually, 46 studies were reviewed out of an initial search of 1434. Results: The review included RCTs involving 3,564 NSCLC patients (Stages I-III). Results indicate that perioperative ICI-chemo combinations improve patient outcomes significantly over chemotherapy alone. Conclusion: In cases of early-stage NSCLC, the perioperative addition of immunotherapy to chemotherapy improves outcomes significantly over chemotherapy alone. Adverse events are still a consideration, yet manageable within the therapeutic window. According to the five endpoints evaluated, nivolumab or toripalimab combined with chemotherapy looks better for stage Ib-IIIb NSCLC. There is probably improved OS (Overall Survival) with Neo compared to Neo-Adj, as adjuvant immunotherapy adds toxicity. Such observations can assist in designing future clinical trials with tailored perioperative ICI therapy for NSCLC. Keywords: immune checkpoint inhibitors, perioperative immunotherapy, non-small cell lung cancer, neoadjuvant therapy, adjuvant therapy, event-free survival, treatment-related adverse events

immune checkpoint inhibitors, perioperative immunotherapy, non-small cell lung cancer, neoadjuvant therapy, adjuvant therapy, event-free survival, treatment-related adverse events

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محمدزاده، محدثه، ضیائی، فائزه، موبد، مهرنگار، فروغی بیوکی، فریماه، باریک رو، نوشین، 1404، اثربخشی و ایمنی ترکیبات مهارکننده نقاط وارسی ایمنی در بیماران مبتلا به سرطان ریه سلول غیر کوچک در دوره پیرامون جراحی، کنگره بین المللی زیست پزشکی سرطان و سلولهای بنیادی، http://conf.sums.ac.ir/fa/archive_index.php?c=HN-icsbc1&aid=1514212