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.

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.

This study reconstructed patient-level data to provide updated evidence on survival outcomes across PD-L1 expression subgroups.

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.

Programmed death (ligand) 1 inhibitors (e.g., avelumab, pembrolizumab, and retifanlimab) are first-line treatment options for patients with locally advanced or metastatic Merkel cell carcinoma (MCC). In the absence of comparative and randomized trials, we aimed to systematically identify and synthesize real-world evidence (RWE) on the effectiveness and safety of immunotherapies in patients with advanced MCC.

Locally advanced or metastatic penile cancer (LA/mPC) is an aggressive and rare malignancy with limited treatment options. While promising, the role of Immune Checkpoint Blockade (ICB) in LA/mPC remains controversial. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of ICB in patients with LA/mPC. A literature search was conducted in PubMed, Embase, and Cochrane (up to June 2025). The analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (CRD420251070583). Proportional outcomes were pooled using a random-effects proportional meta-analysis, and hazard ratios (HR) were pooled using a random-effects model. We used the available Kaplan-Meier curves to recreate time-to-event data from the studies considered. Heterogeneity between studies was evaluated using the I2 metric and Cochran's Q test. A total of 12 cohorts (488 patients) were included in the analysis. The pooled Objective Response Rate in patients treated with ICB was 34.13% (95% CI, 20.62%-56.48%). Subgroup analysis demonstrated marked variability by treatment strategy, with an ORR of 60.7% for ICB plus chemotherapy versus 16.7% for ICB monotherapy (P < .01). At 12 months, pooled Progression-Free Survival (PFS) and Overall Survival (OS) rates were 62.64% (95% CI, 55.55%-70.63%) and 80.21% (95% CI, 74.11%-86.83%), respectively. The median PFS and OS were 5.7 months and 13.6 months, respectively. The pooled incidence of Immune-related Adverse Events was 40.36% (95% CI, 26.82%-60.74%) for any grade and 13.79% (95% CI, 7.67%-24.80%) for grade ≥ 3 events. ICB, particularly when combined with chemotherapy, shows signals of clinical activity in LA/mPC. However, due to high inter-study variability and the single-arm nature of the analysis, these findings are hypothesis-generating and require prospective, randomized, biomarker-driven validation.

The addition of programmed cell death protein-1 (PD-1) inhibitors to chemotherapy (CT) or anti-CTLA4 (ipilimumab) has recently emerged as an effective first-line (1L) treatment for esophageal squamous cell carcinoma (ESCC), the most common form of esophageal cancer globally.

OBJECTIVE: The therapeutic landscape for advanced or metastatic renal cell carcinoma (mRCC) has evolved to incorporate both anti‑VEGF/VEGFR monotherapy and its combination with immune checkpoint inhibitors (ICIs). Direct head‑to‑head comparisons among all available regimens are lacking. This network meta‑analysis (NMA) aimed to comprehensively evaluate their relative efficacy and safety to better inform clinical decision‑making. METHODS: We conducted a Bayesian NMA of randomized controlled trials (RCTs) retrieved from PubMed, Embase, Web of Science, the Cochrane Library and ClinicalTrials.gov up to May 2025. Efficacy outcomes included overall survival (OS), progression-free survival (PFS), and the objective response rate (ORR). Safety outcomes included grade ≥ 3 adverse events (AEs), treatment discontinuation due to AEs, and specific AEs.Treatments were ranked according to the surface under the cumulative ranking curve (SUCRA), which indicates the probability of a regimen being among the best options. RESULTS: A total of 24 randomized controlled trials (RCTs) involving 10,271 patients with advanced or metastatic renal cell carcinoma were included, covering 17 therapeutic approaches. According to SUCRA rankings, toripalimab plus axitinib had the highest probability of ranking first for OS benefit (SUCRA = 0.849) and was significantly superior to tivozanib (HR = 2.14, 95% CI: 1.01–4.64). but not over other comparators.While lenvatinib plus pembrolizumab had the highest probability of ranking first for PFS (SUCRA = 0.939) and showed significant superiority over most monotherapies (e.g., HR = 0.47, 95% CI: 0.34–0.65 vs. sunitinib), its comparative effectiveness was not statistically different from either cabozantinib monotherapy or other ICI-based combinations. Bembelstobart plus anlotinib achieved the highest ORR (SUCRA = 0.972). Regarding grade ≥ 3 AEs, anlotinib monotherapy had the highest probability of ranking as the most favorable option (SUCRA = 0.904), whereas lenvatinib plus pembrolizumab had the highest probability of ranking as the least favorable option (SUCRA = 0.107). Regarding specific adverse events, tivozanib and the 2-week-on/1-week-off sunitinib regimen were ranked as the most favorable options for hand-foot syndrome and fatigue, respectively. For treatment discontinuation due to AEs, bevacizumab plus atezolizumab had the highest probability of being the most favorable option. Subgroup analyses supported the favorable profile of combination therapy in intermediate‑/high‑risk and Asian populations. CONCLUSION: Based on SUCRA rankings, ICI‑based combinations showed more favorable efficacy probabilities than VEGF/VEGFR‑targeted monotherapy. Toripalimab plus axitinib ranked among the best options for overall survival (OS), particularly in Asian and intermediate‑/poor‑risk patients. Although lenvatinib plus pembrolizumab ranked high for progression‑free survival (PFS), its higher probability of severe toxicity requires careful management. Nivolumab plus cabozantinib and bembelstobart plus anlotinib also demonstrated favorable efficacy rankings. For favorable‑risk patients, pazopanib presented a balanced efficacy‑risk profile, with lenvatinib plus pembrolizumab as a potential alternative.

OBJECTIVE: To systematically evaluate the efficacy and safety of chemotherapy combined with PD-1/PD-L1 inhibitors in breast cancer, thereby informing clinical decision-making. METHODS: A comprehensive search was conducted in PubMed, Cochrane Library, Embase, CNKI, Wanfang, and VIP databases from inception to August 2025 for randomized controlled trials (RCTs) comparing chemotherapy plus PD-1/PD-L1 inhibitors versus chemotherapy alone in breast cancer. Two reviewers independently screened studies, extracted data, and assessed quality using the Cochrane risk of bias tool. Meta-analysis was performed using RevMan 5.3. Primary outcomes were progression-free survival (PFS) and pathological complete response (pCR). Secondary outcomes included overall survival (OS), objective response rate (ORR), clinical benefit rate (CBR), and adverse events (AEs). RESULTS: Nineteen RCTs involving 6,546 patients were included. The combination therapy significantly improved pCR(OR = 1.83, 95% CI 1.28–2.62, P < 0.001), PFS (HR = 0.81, 95% CI 0.76–0.87, P < 0.00001), and ORR (OR = 0.62, 95% CI 0.39–0.96, P = 0.03) compared to chemotherapy alone. OS was significantly improved in the combination group (HR = 0.87, 95% CI 0.81–0.94, P = 0.0007). No significant difference was found in CBR (P = 0.07). Safety analysis revealed a higher incidence of grade ≥ 2 AEs (OR = 1.13, P < 0.001), primarily non-hematological toxicities, and a significant increase in immune-related adverse events (irAEs), which were predominantly grade 1–2. Subgroup analyses indicated greater benefit in triple-negative breast cancer (TNBC) and PD-L1-positive populations, with optimal PFS observed with taxane-based regimens. CONCLUSIONS: The addition of PD-1/PD-L1 inhibitors to chemotherapy significantly enhances efficacy in breast cancer, particularly for patients with PD-L1-positive TNBC, at the cost of an increased but manageable risk of low-grade irAEs. Clinical implementation should be guided by biomarker testing and proactive toxicity monitoring.

Clinical trials have demonstrated favorable outcomes with sacituzumab govitecan (SG) in metastatic triple-negative breast cancer (mTNBC). However, significant differences between trial settings and routine clinical practice raise concerns about the real-world prognosis of patients with mTNBC. To address this gap, we conducted the first comprehensive single-arm meta-analysis integrating clinical trials and real-world studies (RWSs) to evaluate clinical outcomes and treatment experiences in mTNBC patients receiving SG.

BACKGROUND: The rise in cholangiocarcinoma (CCA) cases and deaths in China necessitates new treatments. This investigation is designed to establish the comparative efficacy between the coupling of immune checkpoint inhibitors (ICIs) paired with chemotherapy and chemotherapy alone for Chinese individuals diagnosed with CCA. METHOD: Web of Science, Embase, Scopus, the Cochrane Library and PubMed databases were scanned systematically, spanning their initial establishment through June 2025. Overall survival (OS) and progression-free survival (PFS), the primary outcome measures, were demonstrated by the included studies. Included studies specified objective response rate (ORR), adverse events (AEs), and disease control rate (DCR) as secondary endpoints. Engauge Digitizer 11.3 extracted survival curve data points for studies with sole curve data. Calculated: log (HR) = ln (HR), [Formula: see text],[Formula: see text]. RESULTS: The synthesis of the research incorporated findings from eight studies, which altogether assessed 802 cases of cholangiocarcinoma. Combining ICIs with chemotherapy markedly enhanced survival duration. OS had a hazard ratio of 0.46 (95% CI, 0.30–0.58; P < 0.001). PFS had a HR of 0.56 (95% CI, 0.46–0.67; P < 0.001). Higher ORR and DCR were also noted with combination therapy (ORR: risk ratio [RR], 1.34; 95% CI, 1.22–1.48; P < 0.001; DCR: RR, 2.46; 95% CI, 1.84–3.29; P < 0.001). Combination therapy was found, via Kaplan-Meier curves, to significantly increase OS (HR = 0.46, 95% CI 0.39–0.53; P < 0.001); PFS (HR = 0.38, 95% CI 0.35–0.46; P < 0.001). Sensitivity analysis validated stable, OS: HR = 0.46 (95% CI 0.36–0.58, P < 0.001); PFS: HR = 0.56 (95% CI 0.46–0.67, P < 0.001) for ICIs plus chemotherapy treatment. CONCLUSIONS: Adding ICIs to chemotherapy for advanced CCA in China enhances treatment response and survival, without added adverse effects, offering a beneficial and tolerable therapeutic alternative for advanced and recurrent CCA.

Kidney transplant recipients (KTRs) are at increased risk of developing cutaneous squamous cell carcinoma (cSCC), particularly when treated with calcineurin inhibitors (CNI), which are strongly associated with tumorigenesis. In contrast, mTOR inhibitors such as sirolimus have demonstrated antitumor activity, but their role in secondary prevention of cSCC remains unclear. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the impact of switching from a CNI-based to an mTOR inhibitor-based immunosuppressive regimen on the incidence of cSCC in KTRs with prior cSCC. MEDLINE, EMBASE, CENTRAL, and trial registries were searched through June 2025. Incidence rate ratios (IRRs) for cSCC and risk ratios (RRs) for adverse events (AEs) were pooled using a random-effects model. Risk of bias was assessed with Cochrane RoB2. The study was registered in PROSPERO prior to data extraction (CRD42024583966). The study was unfunded. Four RCTs (393 patients) were included. Sirolimus significantly reduced 2-year cSCC incidence (IRR 0.51, 95% CI 0.39-0.67). However, discontinuation was more frequent (RR 8.60, 95% CI 1.95-37.93) due to AEs. No significant differences in mortality or graft rejection were found. Certainty of evidence was high for cSCC incidence and low for adverse events due to heterogeneity and selective reporting. In conclusion, sirolimus reduces secondary cSCC risk but increases AEs; patient selection and monitoring are essential. Trial Registration: PROSPERO number: CRD42024583966.

This study aimed to evaluate whether the Cancer and Aging Research Group (CARG) score is suitable for assessing chemotherapy toxicity risk in older adults with cancer.

Fever in neutropenia (FN) is a potentially lethal complication of chemotherapy for cancer. Prompt administration of broad-spectrum antibiotics is standard of care. Despite conflicting results on the association of time to antibiotics (TTA) with outcomes, TTA limits are used as FN quality measure both in adult and pediatric oncology. This individual patient data (IPD) meta-analysis studied the association between TTA and outcomes in pediatric patients with FN.