BACKGROUND: Unresectable advanced or recurrent gastric and gastroesophageal junction (GC/GEJ) cancers carry poor prognoses, and several programmed death-1 (PD-1) inhibitors have shown clinical activity. However, no head-to-head trial has compared their relative efficacy and safety. This network meta-analysis aimed to evaluate and rank PD-1–based regimens in this setting. METHODS: A systematic review of PubMed, Embase, CENTRAL, Web of Science, and Google Scholar through August 10, 2025, identified randomized controlled trials enrolling adults with unresectable advanced or recurrent GC/GEJ cancer. Primary outcomes were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), treatment-related adverse events (TRAEs), and grade ≥ 3 TRAEs. A Bayesian random-effects network meta-analysis generated mean differences (MDs) or odds ratios (ORs) with 95% confidence intervals (CIs) and calculated surface under the cumulative ranking curve (SUCRA) values. RESULTS: Nineteen trials (n = 9,460) were included. Nivolumab monotherapy ranked first for OS (SUCRA 98.3%) and PFS (97.6%), and improved OS versus control (HR 0.59, 95% CI 0.50–0.69). Sintilimab plus chemotherapy ranked highly for OS and PFS (SUCRA 53.9% and 70.9%) and reduced PFS risk versus pembrolizumab monotherapy (HR 0.53, 95% CI 0.35–0.82). Nivolumab plus chemotherapy also improved OS versus control (HR 0.79, 95% CI 0.68–0.92) and PFS versus pembrolizumab monotherapy (HR 0.55, 95% CI 0.42–0.72). Nivolumab monotherapy yielded the highest ORR and DCR (SUCRA 99.9% and 95.2%) but the lowest safety ranking for grade ≥ 3 TRAEs (SUCRA 7.1%). Pembrolizumab monotherapy showed the most favorable safety (SUCRA 100% for grade ≥ 3 TRAEs) but the lowest efficacy across PFS, ORR, and DCR. Across agents, PD-1 inhibitor–chemotherapy combinations reduced progression or death versus control without increasing severe toxicity. CONCLUSION: Chemoimmunotherapy should be prioritized as first-line therapy for unresectable advanced or recurrent GC/GEJ cancer, with nivolumab-based combinations offering the most favorable efficacy-safety balance. Nivolumab monotherapy provides the strongest tumor response and survival ranking but requires vigilant toxicity management. These comparative rankings can inform individualized regimen selection.

Immune checkpoint inhibitors (ICIs), particularly anti-PD-(L)1s, have transformed cancer care by their extended efficacy, even receiving next-line. Event-free survival 2 (EFS2), progression/recurrence-free survival 2 (PRFS2) and progression-free survival 2 (PFS2) capture the time from randomization to objective recurrence/progression or death on the first subsequent therapy, potentially offering a more accurate measure of durable benefit than first-event endpoints. Our aim is to review the magnitude of this benefit and evaluate long-term endpoints as surrogates for overall survival (OS) in immunotherapy for solid malignancies.

Gastric cancer is a leading cause of cancer-related death worldwide. Peritoneal metastasis (PM) occurs in 5-20 % of patients at diagnosis and is associated with poor prognosis and limited treatment options. Intraperitoneal paclitaxel (IP PTX) has shown variable outcomes in this setting. This study aimed to systematically review and meta-analyze the efficacy and safety of IP PTX-based regimens in gastric cancer with PM. A comprehensive search of PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov identified 253 articles, of which 35 clinical trials (CTs) and randomized controlled trials (RCTs) were included. Screening and data extraction were conducted, with quality assessment performed using the RoB (Risk of Bias) 2.0 tool and the NIH Quality Assessment Questionnaire. Survival outcomes were assessed using median survival time (MST) and 1-year overall survival (OS). Tumor response was evaluated using RECIST criteria. Subgroup analysis was performed for patients undergoing conversion gastrectomy. Safety was assessed by adverse events (AEs). Among 855 patients, the overall pooled MST with IP PTX-based regimens was 20.2 months. Overall cumulative 1-year OS among 785 patients was 71 % (95 % CI: 66-76). In 332 patients undergoing conversion gastrectomy, pooled overall MST was 27 months. For 168 patients who underwent conversion gastrectomy after IP PTX-based regimens, the 1-year OS was 84 % (95 % CI: 77-89). The most common AEs were alopecia (75 %) and anemia (60 %). IP PTX-based regimens appear safe and effective for treating gastric cancer with PM. Subsequent conversion gastrectomy in eligible patients can further improve survival outcomes.

Chemotherapy-induced neutropenia (CIN) may reflect higher pharmacodynamic exposure and relate to improved outcomes, but its clinical relevance in pancreatic cancer remains uncertain.

Existing meta-analyses of anti-vascular endothelial growth factor therapies for neovascular age-related macular degeneration focus mainly on ranibizumab and aflibercept, with limited data on newer agents (faricimab, conbercept). This network meta-analysis (NMA) comprehensively compares all four key agents.

The use of cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6is) in treating hormone receptor positive (HR+) and human epidermal growth factor receptor 2 negative (HER2-) metastatic breast cancer (MBC) have been shown to be effective in prolonging progression-free survival with manageable safety profiles. However, the impact of CDK4/6is on health-related quality of life (HRQoL) is unclear.

Lung cancer (LC) remains the leading cause of cancer-related death worldwide. While immune checkpoint inhibitors (ICIs) have demonstrated survival benefits in advanced-stage disease, treatment responses exhibit significant heterogeneity across patients. The potential role of comorbid chronic obstructive pulmonary disease (COPD) in modulating survival outcomes from ICIs therapy remains controversial, with conflicting evidence regarding its synergistic or antagonistic effects. This meta-analysis systematically evaluates the impact of COPD on survival outcomes in lung cancer patients receiving ICIs, aiming to clarify its prognostic value and guide precision immunotherapy strategies.

OBJECTIVE: This research intended to ascertain the clinical efficacy and safety of anlotinib plus immune checkpoint inhibitors (ICIs) in patients suffering from extensive-stage small cell lung cancer (ES-SCLC). METHODS: Academic databases, encompassing PubMed, Embase, and the Cochrane Library, were retrieved to aggregate pertinent research, published up to March 5, 2025. The primary outcome measures covered progression-free survival (PFS), median PFS (mPFS), overall survival (OS), disease control rate (DCR), and objective response rate (ORR). Additionally, secondary outcome measures comprised partial response (PR), complete response (CR), stable disease (SD), and progressive disease (PD). RESULTS: Data pooled from 18 distinct studies, including 1,698 individuals, were synthesized and analyzed. The results revealed a statistically meaningful increase in PFS and OS for patients who received anlotinib combined with ICIs, as opposed to those receiving chemotherapy alone. Furthermore, with regard to improving ORR and DCR, anlotinib plus ICIs was significantly more efficacious than anlotinib monotherapy and chemotherapy monotherapy (P < 0.05). In comparison to chemotherapy monotherapy, anlotinib plus ICIs exhibited a notably elevated risk of thrombocytopenia (OR: 1.7, 95% CI: 1.19–2.43, P = 0.0034). However, when compared with anlotinib monotherapy, anlotinib plus ICIs did not elevate the incidence of severe adverse events (≥ grade 3). Subgroup analysis results indicated that the Eastern Cooperative Oncology Group (ECOG) performance status (PS) served as an independent predictor influencing both PFS and OS outcomes in individuals with SCLC. In contrast, neither brain metastases nor liver metastases emerged as independent prognostic factors influencing PFS and OS. CONCLUSION: This investigation indicates that anlotinib plus ICIs can extend PFS, elevate ORR and DCR, and prolong OS in individuals with SCLC. This meta-analysis offers new insights into the treatment paradigm for SCLC, indicating that anlotinib plus ICIs can substantially ameliorate clinical outcomes in such patients.

This meta-analysis evaluated the efficacy and safety of combining immune checkpoint inhibitors (ICIs) with chemotherapy in triple-negative breast cancer (TNBC). We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs) comparing immunotherapy plus chemotherapy with chemotherapy alone in TNBC patients, published from inception through 30 June 2022. Outcomes included pathological complete response (pCR), progression-free survival (PFS), overall survival (OS), adverse events (AEs), and immune-related AEs (irAEs), analyzed using hazard ratios (HRs) or odds ratios (ORs). The addition of ICIs to chemotherapy improved pCR (OR 1.90, 95 % CI: 1.28-2.83, *P* = 0.002) and event-free survival (EFS) (HR 0.65, 95 % CI: 0.51-0.82, *P* = 0.0004) in the neoadjuvant setting. Notably, pCR benefits persisted regardless of PD-L1 status (OR 1.65, 95 % CI: 1.26-2.16, *P* = 0.0002 in PD-L1-positive patients; OR 1.56, 95 % CI: 1.04-2.33, *P* = 0.03 in PD-L1-negative patients). In the adjuvant setting, ICIs significantly prolonged PFS in both the intention-to-treat population (HR 0.82, 95 % CI: 0.74-0.90, *P* < 0.0001, *I*² = 0 %) and PD-L1-positive subgroups (HR 0.71, 95 % CI: 0.62-0.82, *P* < 0.00001, *I*² = 12 %). However, combination therapy increased the incidence of any-grade AEs, serious AEs, and grade ≥3 AEs in neoadjuvant treatment. The experimental group also exhibited higher toxicity for irAEs, including hypothyroidism and hyperthyroidism. These findings support the use of ICIs with chemotherapy for TNBC, though careful monitoring of adverse effects is warranted. PROSPERO registration number:CRD42022367366.

BACKGROUNDS: The treatment of locally advanced nasopharyngeal carcinoma(LA-NPC) is challenged by recurrence and metastasis(R/M), and even though concurrent chemoradiotherapy(CRT) is the standard regimen, new strategies are urgently needed to improve patient prognosis. In recent years, PD-1/PD-L1 inhibitors, as an important representative of immunotherapy, have shown potential in several studies. However, systematic evidence on the efficacy and safety of PD-1/PD-L1 inhibitors in LA-NPC is insufficient. Therefore, this study aimed to comprehensively assess the efficacy and safety of PD-1/PD-L1 inhibitors in LA-NPC treatment by systematic review and meta-analysis methods. METHODS: We systematically searched Medline, Embase, and the Cochrane Library (as of March 2025) using subject terms combined with free words to include all randomized controlled trials (RCTs) on PD-1 or PD-L1 inhibitors for LA-NPC. The primary outcome metrics were progression-free survival (PFS), overall survival (OS), event-free survival (EFS), and grade ≥ 3 adverse events (AEs). We conducted a systematic review and meta-analysis of studies that met the inclusion criteria. RESULTS: A total of 2 studies involving 575 participants were included. This meta-analysis showed that patients who received PD-1 inhibitor monotherapy combined with CRT had improved PFS (HR: 0.40, 95% CI: 0.18–0.89) and EFS (HR: 0.59, 95% CI: 0.38–0.92). For distant metastasis rate and locoregional recurrence rate, PD-1 inhibitor monotherapy combined with CRT was more effective, reaching (OR: 0.50,95% CI: 0.30–0.85 I²=0%, P = 0.8) and (OR: 0.43,95% CI: 0.22–0.81 I²=39%, P = 0.2), respectively, which were significantly lower than patients who received only CRT. However, there was no significant difference in OS (HR: 0.83, 95% CI: 0.48–1.43,I²=0%, P = 0.34). Safety analysis showed that PD-1 inhibitor treatment was accompanied by a significantly increased risk of immune-related adverse events(IRAEs)(Peto OR: 11.14, 95% CI: 7.79–15.93 I²=93%, P < 0.0001) and incidence of > = grade 3 AEs (OR: 1.50, 95% CI: 1.04–2.17 I²=0%, P = 0.7). RESULTS: The meta-analysis showed that PD-1 inhibitors combined with CRT in LA-NPC improved their disease control (in terms of PFS and EFS) and reduced disease recurrence and metastasis, but the effect on OS is unknown and increases the risk of IRAEs. The current evidence is based on limited study data, and its exact efficacy and safety need to be confirmed with more high-quality data.

Immune checkpoint inhibitors (ICIs) are under extensive investigation as a treatment for triple-negative breast cancer (TNBC) in numerous trials. Given the need to evaluate their therapeutic profile, we conducted this systematic review and meta-analysis to comprehensively assess the safety and efficacy of ICI therapy for TNBC.

Chemotherapy-induced alopecia (CIA) affects approximately 65% of patients receiving chemotherapy and has a negative impact on quality of life (QoL). Scalp cooling (SC) is the only FDA-cleared intervention for CIA. This systematic review and meta-analysis evaluated SC adverse events (AEs), reasons for discontinuation, and scalp metastasis incidence.

Recent advancements highlight promising outcomes with immune checkpoint inhibitors (ICIs) when combined with concurrent chemoradiotherapy (CCRT) or chemotherapy in the treatment of locally advanced cervical cancer (LACC). This systematic review and meta-analysis aimed to assess the efficacy and safety of ICIs combined with CCRT/chemotherapy in patients with LACC.

Cisplatin causes nephrotoxicity in approximately 30% of patients. Mannitol has been proposed as a nephroprotective agent, yet the clinical evidence remains inconclusive.

This systematic review and meta-analysis evaluated whether compression therapy prevents chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients receiving taxanes.

Recent advancements in tumor therapy have centered on novel treatments, particularly immune checkpoint inhibitors (ICIs), which have transformed cancer treatment since their global approval in 2011. ICIs have demonstrated remarkable and substantial efficacy across a range of malignancies, including malignant melanoma, non-small cell lung cancer (NSCLC), head and neck cancers, renal carcinoma, and selected gastrointestinal cancers. Despite these promising outcomes, the challenges that during the clinical application, such as relatively low response rates and the occurrence of immune-related adverse events, can limit therapeutic benefits. Accumulating evidence highlights the gut microbiome as a critical modulator of cancer immunotherapy efficacy. Notably, alterations in gut microbiota composition observed in response to ICI therapy, and specific bacterial populations (such as an increased Clostridiales/ Baceroidales ratio, etc.) have been associated with improved responses in patients with NSCLC and renal cell carcinoma. However, the composition and function of the gut microbiome are influenced by a variety of factors, among which concomitant drug use plays a particularly prominent role. Medications commonly prescribed to cancer patients, such as antibiotics, proton pump inhibitors (PPIs), and probiotics, can significantly alter microbial communities, potentially impacting immunotherapy outcomes. Thus, there is a compelling need for rigorous research to elucidate how such drug-induced shifts in gut microbiota affect patient responses to ICIs. Thus, we conducted a meta-analysis which included 69 studies, 102 cohorts (22,568 patients were included) to systematically investigate the influence of drug interventions, including PPIs, antibiotics and probiotics on gut microbiome dynamics and ICI effectiveness. Progression-free survival (PFS), Overall survival (OS) and Objective response rate (ORR) were utilized as the main meta notions, while a subgroup analysis was determined based on: (1) tumor type; (2) exposure time window; (3) Treatment scheme as well. The total HR and 95% CI for PFS and OS are calculated separately for each intervention (probiotics, antibiotics, and PPIs) to compare their impact on ICI immunotherapy. Our research showed that the concurrent use of antibiotics or PPIs with ICIs was associated with significantly OS, PFS, and ORR. In contrast, probiotic supplementation demonstrated promising results with improved efficacy metrics. Besides, in subgroup analysis, patients using antibiotics within three months before or after the initiation of ICI therapy, OS, PFS, and ORR were significantly lower compared to those who did not receive antibiotics; the timing of antibiotic or PPI administration consistently resulted in poorer outcomes; a negative correlation between PPI use and OS, PFS, and ORR across treatment modalities was also exhibited. By elucidating the interplay between these factors, this study aims to provide robust evidence for optimizing ICI therapy, and to enlighten cancer treatment strategies more personalized, effective and safer, ultimately advancing patient care in oncology.

Trastuzumab deruxtecan (T-DXd) is a novel antibody-drug conjugate uesd for the treatment of HER2- positive (HER2+)breast cancer. This systematic review aimed to evaluate the efficacy and safety of T-DXd in advanced HER2-positive breast cancer.

Cancer immunotherapy (CIT) often triggers immune-related adverse events (irAEs). Analysis of irAEs in large checkpoint inhibitor (CPI) trials has enhanced their management and demonstrated their prognostic value for treatment outcome. However, data on irAEs in non-standard CITs are limited, and systematic exploration is lacking. Identifying predictive biomarkers for irAEs in these therapies is still emerging and essential for improving patient care.

Despite the established efficacy of immune checkpoint inhibitors (ICIs) in combination with chemotherapy, with or without anti-angiogenic agents, for extensive-stage small-cell lung cancer (ES-SCLC), a comprehensive comparative assessment of these regimens remains lacking. This study aimed to systematically compare the safety, efficacy, and cost-effectiveness of currently available ICI combination regimens for ES-SCLC.

This meta-analysis compared the efficacy and safety of degarelix and GnRH agonists in prostate cancer treatment.