Early studies indicate that neoadjuvant immune checkpoint inhibitors (ICIs) induce high rates of tumor regression in localized deficient mismatch repair (dMMR) and microsatellite instability-high (MSI-H) gastric and gastroesophageal junction (GEJ) cancers, raising interest in nonoperative management (NOM). Most available data, however, come from small, nonrandomized cohorts. A systematic synthesis was undertaken to better characterize efficacy and safety outcomes.

Triple-negative breast cancer (TNBC), an aggressive subtype lacking oestrogen and progesterone receptors and amplification of HER2 receptors, accounts for 12% to 17% of breast cancers. Adjuvant and neoadjuvant chemotherapy improve survival; however, 30% to 40% of early-stage TNBC cases progress to metastatic disease. Recent evidence suggests that combining immune checkpoint inhibitors (PD-1/PD-L1 inhibitors) with chemotherapy may improve pathological complete response and event-free survival.

This study explored whether integrating innovative immunotherapies targeting costimulatory or co-inhibitory pathways beyond standard PD-1, PD-L1, and CTLA-4 treatments affects hepatic adverse events. We further analyzed liver-related side effects in patients with cancer receiving these novel therapies alone or in combination with others.

Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent adverse effect linked to neurotoxic chemotherapeutic agents. Current pharmacological treatments exhibit limited efficacy and notable adverse effects. The clinical effectiveness of non-pharmacological therapies, like acupuncture, physical exercise (PE), cryotherapy (CR), and compression therapy, requires systematic comparison. This study employs a network meta-analysis (NMA) to appraise the efficacy and preventive effects of various non-pharmacological interventions on CIPN.

Nasopharyngeal carcinoma (NPC), endemic to Southern China and Southeast Asia, presents significant clinical challenges. Immune checkpoint inhibitors (ICIs) have transformed NPC treatment but carry risks of immune-related adverse events (irAEs). Existing meta-analyses lack NPC-specific data, hindering targeted safety guidance.

Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible vision loss in older adults. Intravitreal anti-vascular endothelial growth factor (VEGF) agents-including Aflibercept, Ranibizumab, Bevacizumab, Brolucizumab, and Faricimab-are the mainstay of therapy. However, their comparative efficacy and safety remain uncertain. This study aimed to compare the visual and systemic outcomes of these agents to inform clinical decision-making.

Immune checkpoint inhibitors (ICIs) are increasingly used in oncology, but concerns persist regarding flare risks of pre-existing rheumatologic diseases in patients receiving ICIs. This meta-analysis study aims to evaluate the incidence and severity of rheumatologic disease flares in patients with solid tumors treated with ICIs.

Several studies have explored the impact of immune checkpoint inhibitor (ICI)-induced immune-related thyroid dysfunction on the prognosis of patients with lung cancer. However, inconsistencies remain among the results of different studies. Therefore, we conducted a meta-analysis to evaluate the impact of immune-related thyroid dysfunction on the prognosis of lung cancer, aiming to provide evidence-based support for clinical treatment.

Checkpoint inhibitors that target PD-1 or PD-L1 have had a profound effect in a variety of cancers, both as a single therapy and in combinations. Meta-analyses suggest that monoclonal antibodies (mAbs) targeting PD-1 may yield better survival outcomes compared to anti-PD-L1 mAbs, however these conclusions are limited by a lack of direct clinical comparisons between the two classes. There is a shared hypothesis for the mechanism of action of these drugs: inhibition of the PD-1:PD-L1 signaling pathway through binding to either target. Using a Quantitative Systems Pharmacology (QSP) model-based analysis, we test whether differential inhibition of PD-1:PD-L1 complex formation (a surrogate for inhibition of the signaling pathway) is sufficient to explain the efficacy difference between anti-PD-1 and anti-PD-L1 mAbs observed in clinical meta-analyses. The model predicts that high levels of PD-1:PD-L1 complex inhibition are achieved by all the considered mAbs at their clinical dosing regimens, but it does not indicate that anti-PD-1 mAbs yield higher inhibition over anti-PD-L1s, in contrast to the meta-analyses. Significant model parameter variability and a bootstrap sampling analysis mirroring the comparison from Duan et al. (2020) do not change this conclusion. This suggests that anti-PD-1 and anti-PD-L1 mAbs are not differentiable based on PD-1:PD-L1 complex inhibition alone, and that the hypothesized shared mechanism of action of the two classes of drugs is incomplete.

Immunotherapy has transformed the therapeutic landscape of breast cancer. Nevertheless, an exhaustive overview of the treatment-related adverse events (TRAEs) and immune-related adverse events (irAEs) spectrum of immune checkpoint inhibitor (ICI)-based combination therapies remains lacking. We performed a comprehensive systematic review and meta-analysis comparing chemotherapy, antibody-drug conjugate (ADC) therapy, targeted therapy, immunotherapy, endocrine therapy, radiotherapy, and dual therapy combined with ICIs. The primary outcomes were overall incidence rates and profiles for all-grade and grade 3 or higher TRAEs and irAEs according to random effects models. We identified 8236 records, 100 of which (9192 patients) met the inclusion criteria. For grade ≥ 3 TRAEs, the ICI-based chemotherapy and ICI-based ADC regimens demonstrated equivalent incidence rates, marginally exceeding those observed in the ICI-based targeted therapy group. Analysis of irAEs revealed that ICI-based chemotherapy combinations had a significantly lower incidence than other dual-agent regimens did. In triplet regimens that combined ICIs with chemotherapy plus additional immunotherapy, irAEs rates remained nearly comparable to those of dual therapies. Among the therapeutic regimens analyzed, ICIs combined with multitarget tyrosine kinase inhibitors (mTKIs) presented the highest incidence rates of both all-grade and grade ≥ 3 irAEs. Conversely, combination regimens of ICIs with poly ADP-ribose polymerase (PARP) inhibitors or HER2-targeted monotherapy demonstrated markedly lower risks of irAEs. Our study provides comprehensive data on the TRAEs and irAEs associated with ICI-based combination therapies. These results offer direct and practical references for clinicians to evaluate toxicity profiles and optimize treatment decisions in routine breast cancer care.

Bevacizumab only improves progression-free survival (PFS) but not overall survival (OS) in glioblastoma (GBM) patients. Drug-induced hypertension is a common adverse event associated with bevacizumab in GBM, and it may paradoxically be associated with a favorable treatment response. However, the prognostic role of hypertension as a biomarker for bevacizumab efficacy in GBM remains unresolved. This study aimed to systematically evaluate the prognostic role of drug-induced hypertension in GBM patients treated with bevacizumab. We included studies on hypertension and survival outcomes in GBM patients treated with angiogenesis inhibitors from PubMed, Cochrane Library, and Web of Science databases. We extracted time-to-event data, including hazard ratios, and reconstructed individualized patient data from Kaplan-Meier curves. We used a meta-analysis approach to analyze pooled hazard ratio outcomes. A total of 1082 patients were included from 7 studies. Of these, 215 (24.8%) patients developed drug-induced hypertension, while 867 (75.2%) patients were normotensive. Compared to normotensive patients, patients who developed drug-induced hypertension showed a median benefit of PFS ranging from 2 to 8 months and OS ranging from 4 to 10 months in individual studies. Pooled time-to-event analysis showed that drug-induced hypertension significantly prolonged both PFS (HR = 0.44; 95% CI:0.28-0.70; p = 0.008) and OS (HR = 0.50; 95% CI:0.30-0.83; p = 0.015). Meta-regression demonstrated that earlier onset of hypertension may confer a greater survival benefit (PFS: β = 0.0078, OS: β = 0.0056), and subgroup analysis indicated that a ≥ 140/90 mmHg threshold may serve as a practical biomarker cutoff. In conclusion, this meta-analysis suggest that drug-induced hypertension is significantly associated with improved PFS and OS in bevacizumab-treated GBM patients. These findings suggest its potential as a positive prognostic biomarker, warranting further prospective validation.

Neoadjuvant immunochemotherapy (nICT) has emerged as a promising perioperative strategy for locally advanced gastric and gastroesophageal junction cancer (LAGC/EGJC), yet its survival benefit beyond pathological response and optimal patient selection remain uncertain. We conducted a systematic review and meta-analysis to evaluate the efficacy, safety, and biomarker stratification of nICT compared with neoadjuvant chemotherapy (nCT). PubMed, Embase, Web of Science, and the Cochrane Library were searched through August 30, 2025. Comparative studies of nICT versus nCT and single-arm nICT cohorts were included. Overall survival (OS) and recurrence-free survival (RFS) were primary outcomes. Fifteen comparative studies and thirty-four single-arm or biomarker datasets were included. Compared with nCT, nICT significantly improved OS (HR = 0.80, 95 % CI 0.70-0.92) and RFS (HR = 0.78, 95 % CI 0.69-0.87), and achieved higher pathological complete response, major pathological response, and R0 resection rates. Although treatment-related adverse events were more frequent with nICT, postoperative recovery and complication rates were comparable. Single-arm analyses showed pooled pathological complete and major pathological response rates of approximately 20 % and 43 %, with encouraging 2-year OS and RFS. Biomarker analyses demonstrated enrichment of pathological response in patients with PD-L1 CPS ≥ 1/≥ 5 and dMMR/MSI-H, whereas tumor mutational burden and Epstein-Barr virus status showed inconsistent discriminatory value. Meta-regression revealed no significant effect modification. Overall, nICT provides pathological and early survival improvement without compromising perioperative safety, supporting its integration into perioperative strategies for LAGC/EGJC.

Although trastuzumab deruxtecan (T-DXd) demonstrated unprecedented intracranial efficacy in HER2-positive breast cancer brain metastases (BCBM), its association with interstitial lung disease (ILD)/pneumonitis posed a critical safety concern in this high-risk population. Previous safety assessments lacked BCBM-specific analysis of ILD.

Anthracycline-induced cardiotoxicity is a major cause of morbidity in breast cancer survivors. Although left ventricular ejection fraction (LVEF) is the gold standard for monitoring cardiac function, it is often considered a late and insensitive marker of myocardial damage. New methods have emerged: global longitudinal strain (GLS) and cardiac magnetic resonance (CMR) derived parameters as potentially superior tools for detecting subclinical dysfunction. This study aimed to systematically compare the diagnostic accuracy and temporal sensitivity of GLS, LVEF, and CMR índices in the early detection of chemotherapy-induced cardiotoxicity.

Cisplatin-based concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced cervical cancer; however, its nephrotoxicity and gastrointestinal toxicity often limit treatment eligibility and completion. Nedaplatin, a cisplatin analogue with reduced renal and gastrointestinal toxicity, has been increasingly used in East Asia, but its comparative efficacy and safety in cervical cancer have not been comprehensively evaluated.

Elderly frail cancer patients face reduced chemotherapy tolerance and higher complications. Exercise intervention shows promise, but evidence remains limited. To evaluate exercise management's impact on chemotherapy tolerance and complications in this population via systematic review and meta-analysis. Randomized controlled trials (RCTs) were retrieved from databases including PubMed and Embase from inception to July 2025. Elderly cancer patients aged ≥65 years with frailty (per standard diagnostic criteria) undergoing chemotherapy were included, comparing exercise intervention with conventional care. The Cochrane ROB 2.0 tool was used for quality assessment, and RevMan 5.4 software was employed for meta-analysis. Effect sizes were expressed as mean difference (MD), odds ratio (OR), and 95% confidence interval (CI). 18 RCTs (1655 patients) showed exercise significantly reduced complication rates (OR = 0.41, P = 0.01), severe complications (OR = 0.39, P = 0.003), improved 12-minute walking distance (MD = 45.64, P = 0.02), decreased fatigue (MD=-0.80, P = 0.002), and improved quality of life (MD=-6.11, P < 0.001). No effects on Comprehensive Complication Index or readmission rates (P > 0.05). Exercise management is a safe and effective non-pharmacological intervention that reduces chemotherapy complication risks, improves functional status, and enhances quality of life in elderly frail cancer patients. It is recommended as a supportive therapy during chemotherapy, prioritizing comprehensive exercise programs (aerobic plus resistance training), administered 3-5 times weekly for 30-60 minutes over 8-12 weeks. Individualized protocols should be developed by multidisciplinary teams (oncology, rehabilitation, and geriatrics) with dynamic tolerance assessment.

To investigate the efficacy and safety of Cadonilimab in patients with metastatic, recurrent, and advanced cervical cancer.

Background: Chemotherapy-induced nausea and vomiting (CINV) is a common treatment-related side effect that has a detrimental effect on the quality of life of patients with cancer and may lead to dose reductions or discontinuation of chemotherapy. This meta-analysis aims to explore the efficacy and safety of olanzapine plus triple antiemetic therapy for prevention of delayed-phase platinum-based CINV. Methods: Electronic databases (five English databases: (I) PubMed, (II) ScienceDirect, (III) The Cochrane Library, (IV) Scopus, and (V) EMBASE, and two Chinese databases: China National Knowledge Infrastructure and Wanfang Database) were searched for trials that evaluated the effectiveness and safety of olanzapine plus triple antiemetic in preventing platinum-based CINV. Efficacy was no nausea, complete control, and complete response (CR) rates in the acute, delayed, and overall phases after chemotherapy. Data were analyzed using the random effects model and fixed effects model. Results: A total of 18 trials involving 3110 patients were identified, including 9 controlled trials and 9 single-arm trials. The meta-analysis of nine studies, which showed significant heterogeneity (p = 0.002, I2 = 67%), demonstrated that the olanzapine (OLN) group had a significantly higher rate of delayed CR compared to the control group (OR: 2.33, 95% CI: 1.57-3.46, p < 0.00001). Compared with the Without OLN group, the With OLN group had a significant overall CR (OR: 2.18, 95% CI: 1.80-2.63, p < 0.00001, heterogeneity: p < 0.00001, I2 = 69%), and a significant acute CR (OR: 2.28, 95% CI: 1.45-3.58, p < 0.00001, heterogeneity: p = 0.04, I2 = 51%). The meta-analysis revealed that the With OLN group could significantly increase the risk of dry mouth compared to the Without OLN group (OR  =  2.60, 95% CI: 1.73-3.91). In terms of insomnia, the odds ratio for the With OLN group was significantly lower than that for the Without OLN group (OR = 0.60; 95% CI 0.41-0.89). Conclusions: The results of this meta-analysis provide robust evidence that adding olanzapine to standard triple therapy significantly improves the prevention of platinum-based delayed-phase CINV, a setting where current antiemetic regimens often prove suboptimal. However, it also increases the risk of certain adverse events, especially dry mouth. Clinical decisions should be made based on a thorough assessment of the therapeutic benefits and safety risks.

The addition of immune checkpoint inhibitors (ICIs) to perioperative treatment for resectable gastric or gastroesophageal junction (GEJ) cancers has shown promising results. However, current pivotal trials (KEYNOTE-585 and MATTERHORN) have reported conflicting survival outcomes. To clarify their therapeutic value, we conducted a meta-analysis evaluating the efficacy and safety of adding ICIs to this population.

Several clinical trials have explored the efficacy and safety of Poly (ADP-ribose) polymerase (PARP) inhibitors in endometrial cancer (EC). However, evidence supporting PARP inhibitors alone or in combination with other medications in advanced or recurrent EC remains limited.