针对程序性细胞死亡蛋白 1 (PD-1) 的免疫检查点抑制剂 (ICIs) 的广泛使用在多种实体瘤的治疗中取得了重大进展。本荟萃分析旨在评估新辅助化疗 (NCT) 加 PD-1 抑制剂治疗局部进展期胃癌 (LAGC) 患者的安全性和有效性。通过 PubMed、EmBase 和 Cochrane 图书馆的电子检索来确定NCT PD-1 抑制剂与 NCT 在 LAGC 患者中的临床试验。检索期限自相应数据库建立起延长至2024年4月，并使用Stata（15版）软件进行荟萃分析。随后，使用直接比较分析来比较新辅助免疫化疗（NICT）与NCT的汇总结果。筛选后，纳入了6项II/III期随机对照试验（RCT）和9项回顾性研究，涉及2,953名患者。在荟萃分析中，与NCT相比，NICT组的病理完全缓解率（pCR）（P<0.001）和R0切除率（P=0.001）显着较高，2年复发率较低（P=0.001）团体。然而，NICT 组的严重治疗相关不良事件 (TRAE) 发生率较高 (P=0.044)。此外，NICT组和NCT组在淋巴结获取数量、TRAE总数、术后并发症发生率、术后住院时间等方面均无统计学差异。 LAGC患者联合PD-1抑制剂NCT提高了实现根治性手术的可能性并改善预后，尽管在一定程度上增加了严重 TRAE 的风险。 NICT 预计将成为 LAGC 患者的首选新辅助治疗选择。版权所有 © 2024 作者。由 Wolters Kluwer Health, Inc. 出版

The extensive utilization of immune checkpoint inhibitors (ICIs) targeting programmed cell death protein 1 (PD-1) has achieved significant advancements in the treatment of diverse solid tumors. The present meta-analysis aims to evaluate the safety and efficacy of neoadjuvant chemotherapy (NCT) plus PD-1 inhibitor for patients with locally advanced gastric cancer (LAGC).An electronic search of PubMed, EmBase, and the Cochrane Library was performed to identify the clinical trials of NCT + PD-1 inhibitor vs. NCT in patients with LAGC. The retrieval period extended from the establishment of the corresponding database until April 2024, and meta-analysis was conducted using Stata (version 15) software. Subsequently, direct comparative analysis was used to compare pooled results of neoadjuvant immunochemotherapy (NICT) with NCT.After screening, 6 phase II/III randomized controlled trials (RCTs) and 9 retrospective studies with 2,953 patients were included. In meta-analysis, NICT group demonstrated a significantly higher rate of pathological complete response (pCR) (P<0.001) and R0 resection (P=0.001), and a lower 2-year recurrence rate (P=0.001) compared to the NCT group. The NICT group, however, exhibited a higher incidence of severe treatment-related adverse events (TRAEs) (P=0.044). Additionally, the NICT and NCT groups exhibited no statistical differences in terms of the number of harvested lymph nodes, the occurrence of total TRAEs and postoperative complications, as well as the duration of postoperative hospitalization.The combination of PD-1 inhibitor + NCT in LAGC patients enhances the likelihood of achieving radical surgery and improves prognosis, albeit to some extent increasing the risk of severe TRAEs. NICT is anticipated to emerge as the preferred neoadjuvant therapy option for patients diagnosed with LAGC.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.