Clinicopathological and molecular characteristics associated with pathological complete response in neoadjuvant immunotherapy for breast cancer

作者：Buchen Zhang, Zhuo Chen, Runzhi Mao, Jinfeng Zhu, Wenjie Cai, Bing Zhao · 发表于：Frontiers in Immunology · 年份：2026 · DOI：10.3389/fimmu.2026.1771228 · 被引用次数：1 · 研究领域：Breast Cancer Treatment Studies、Cancer Immunotherapy and Biomarkers、Immunotherapy and Immune Responses

Background In breast cancer, immune checkpoint inhibitor (ICI)-based neoadjuvant therapy has been approved for clinical practice since 2021. Nonetheless, the predictive values of routinely collected clinicopathological and molecular characteristics in neoadjuvant immunotherapy remain unknown. Methods We searched EMBASE and MEDLINE databases for randomized controlled trials (RCTs) comparing ICI-based neoadjuvant therapy with conventional treatment. The primary outcome was pathological complete response (pCR). The odds ratio (OR) and its 95% confidence intervals (CIs) were calculated. This meta-analysis was registered in PROSPERO (CRD420261307112). Results Here, with 5674 patients enrolled in 12 RCTs, our study revealed ICI-based neoadjuvant therapy was associated with significantly increased pCRs (OR, 1.59; 95% CI, 1.32-1.90; P < 0.001). Notably, neoadjuvant immunotherapy did not demonstrate a statistically significant improvement of pCRs in patients with HER2+ tumors (OR, 1.17; 95% CI, 0.92-1.49; P = 0.23). Moreover, the interactions between ICI-based neoadjuvant therapy and nodal status ( P Interaction < 0.001) or stromal tumor-infiltrating lymphocyte (sTIL, P Interaction = 0.05) were statistically meaningful. More pCRs were observed in patients with nodal-positive (OR, 1.89; 95% CI, 1.56-2.28; P < 0.001) or high-density sTIL tumors (OR, 2.89; 95% CI, 1.49-5.61; P < 0.001), but not in women with nodal-negative (OR, 1.05; 95% CI, 0.80-1.39; P = 0.7...