Objective To systematically evaluate the effect and safety of neoadjuvant PD-1/PD-L1 inhibitors combined with chemotherapy for resectable non-small cell lung cancer (NSCLC). Methods The PubMed, EMbase, The Cochrane Library, CNKI, and Wanfang data were searched by computer to identify relevant studies on anti PD-1 /PD-L1 combined with chemotherapy for resectable NSCLC from inception to March 2023. Two authors independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. The single-arm study was evaluated for quality using the methodological index for non-randomized studies (MINORS). Meta-analysis was conducted by RevMan 5.4 software. Results Twenty-six studies with 965 patients were included in this meta-analysis. MINORS scores of single-arm studies were ≥12 points. The meta-analysis results showed that the pooled pathologic complete response, major pathologic response, and objective response rates as well as partial response, surgical rate and R0 surgical resection rate of neoadjuvant PD-1/PD-L1 inhibitors combined with chemotherapy were 39% [RD=0.39, 95%CI (0.31, 0.47) ], 59% [RD=0.59, 95%CI (0.53, 0.65) ], 72% [RD=0.72, 95%CI (0.65, 0.80) ], 62% [RD=0.62, 95%CI (0.56, 0.69) ], 86% [RD=0.86, 95%CI (0.81, 0.92) ], and 94% [RD=0.94, 95%CI (0.92, 0.97) ], respectively. In terms of safety, the rate of adverse events (AEs) was 65% [RD=0.65, 95%CI (0.52, 0.78) ], and the rate of grade 3 to 5 AEs was 16% [RD=0.16, 95%CI (0.10, 0.23) ]. Conclusion The combination of neoadjuvant PD-1/PD-L1 inhibitors with chemotherapy has good efficacy and safety in the treatment of patients with resectable NSCLC.
Objective To assess the evolving disease burden of esophageal and gastric cancers in China from 1990 to 2021, with a focus on gender disparities, and construct a predictive model to forecast disease trends from 2022 to 2031, aiming to optimize targeted prevention strategies. MethodsEpidemiological data for esophageal and gastric cancers in China (1990-2021) were extracted from the Global Burden of Disease (GBD 2021) database. Temporal trends were analyzed using Joinpoint regression (version 4.9.1.0), and future trends were predicted via the GM (1,1) model under grey system theory. ResultsFrom 1990 to 2021, tobacco- and alcohol-attributable burdens of esophageal cancer increased, while tobacco- and diet-related burdens of gastric cancer declined. Deaths and disability-adjusted life years (DALY) for esophageal cancer rose by 26.38% and 17.89%, respectively; gastric cancer deaths increased by 18.95%, though DALY decreased by 1.22%. Both cancers exhibited significant declines in age-standardized mortality rates (−45.78% for esophageal cancer, −53.29% for gastric cancer) and age-standardized DALY rates (−51.36% for esophageal cancer, −57.58% for gastric cancer). Despite these reductions, China’s age-standardized mortality and DALY rates for both cancers remained consistently higher than global averages, with slower decline rates. Males exhibited disproportionately higher burdens than females. Predictive modeling projected continued but decelerating declines in disease burdens for both cancers by 2031. ConclusionOver three decades, China achieved measurable reductions in esophageal and gastric cancer burdens, though gastric cancer burdens remained higher than esophageal cancer. Persistent disparities relative to global levels, elevated male burdens, and aging demographics highlight the urgency for prioritized interventions targeting high-risk populations.
