{
  "abstract": "Background: Multiple RCTs have established PD-1/PD-L1 inhibitors as standard in triple-negative breast cancer (TNBC), but prior meta-analyses lacked complete setting coverage, mature long-term survival data, and a quantification of chemotherapy-backbone impact—critical given IMpassion130 (nab-paclitaxel, positive) vs. IMpassion131 (paclitaxel, negative). This update includes final KEYNOTE-522 OS, GeparNuevo 7-year follow-up, and TORCHLIGHT Phase III data, covering neoadjuvant to metastatic disease.\n\nMethods: We searched PubMed and ClinicalTrials.gov to May 2026 plus conference proceedings; an Embase search found no additional trials. Included RCTs compared ICI + chemotherapy vs. chemotherapy alone in TNBC, stratified by setting. The primary endpoints are OS (metastatic) and EFS/iDFS (early-stage). Pooled HRs used random-effects meta-analysis with HKSJ adjustment.\n\nResults: A total of 10 RCTs (5,953 patients) met the inclusion. In the metastatic setting (five RCTs, n = 3,526), ICI improved OS (HR 0.85, 95% CI 0.74–0.96; HKSJ-adjusted 0.70–1.03; I ² = 27%) and PFS (HR 0.82, 0.73–0.92; I ² = 35%); OS benefit was greater in PD-L1+ patients (HR 0.79, 0.65–0.95; I ² = 51%). Numerically greater OS with anti-PD-1 vs. anti-PD-L1 was not robust in the sensitivity analysis. In the early-stage setting (five RCTs, n = 2,427), ICIs improved EFS/iDFS (HR 0.75, 0.63–0.90; I ² = 0.2%) and OS (HR 0.64, 0.53–0.78; I ² = 0%) and increased pCR (OR 1.65, 1.39–1.98; I ² = 1%). HKSJ adjustment widened the Cis, but the effect patterns remained consistent.\n\nConclusions: This update confirms a consistent survival benefit of ICI + chemotherapy in both early and metastatic TNBC, which was most pronounced in PD-L1+ populations. Long-term data show durability, especially in neoadjuvant/adjuvant settings. The divergent outcomes with nab-paclitaxel vs. paclitaxel underscore the critical role of the chemotherapy backbone. These findings support current guidelines and highlight the need for refined biomarkers to extend benefit to PD-L1-negative patients.\n\nSystematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261356428 , identifier CRD420261356428.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pathology, Suzhou BenQ Medical Center"
  ],
  "article_type": "systematic review",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Bing Guan"
    },
    {
      "affs": [
        0
      ],
      "name": "Yawen Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Rong Zhou"
    },
    {
      "affs": [
        0
      ],
      "name": "Sijia Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Lulu Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Ping He"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1z5zg1fw48yxn.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1958007",
  "fulltext_url": "https://europepmc.org/articles/PMC13680397",
  "id": "1z5zg1fw48yxn",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1958007/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2730|Cancer Immunotherapy and Biomarkers"
    ]
  ],
  "openalex": "W7220674414",
  "pdf_url": "https://europepmc.org/articles/PMC13680397?pdf=render",
  "pmcid": "PMC13680397",
  "pmid": "42903114",
  "published": "2026-10-06",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/1z5zg1fw48yxn.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:15Z",
      "native_id": "10.3389/fimmu.2026.1958007",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1958007/full"
    },
    {
      "first_seen": "2026-10-30T12:19:57Z",
      "native_id": "MED:42903114",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42903114"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Cancer Immunotherapy and Biomarkers",
      "subfield": "oncology"
    }
  ],
  "title": "PD-1/PD-L1 inhibitors combined with chemotherapy or as monotherapy versus chemotherapy alone or observation in triple-negative breast cancer: a systematic review and updated meta-analysis incorporating long-term survival data",
  "title_text": "PD-1/PD-L1 inhibitors combined with chemotherapy or as monotherapy versus chemotherapy alone or observation in triple-negative breast cancer: a systematic review and updated meta-analysis incorporating long-term survival data",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:57Z",
  "url": "https://research.draconitic.com/paper/1z5zg1fw48yxn",
  "venue": "Frontiers in Immunology",
  "versions": []
}