{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T12:22:47Z","timestamp":1783513367038,"version":"3.55.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001). 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;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.23). Moreover, the interactions between ICI-based neoadjuvant therapy and nodal status (\n                      <jats:italic>\n                        P\n                        <jats:sub>Interaction<\/jats:sub>\n                      <\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001) or stromal tumor-infiltrating lymphocyte (sTIL,\n                      <jats:italic>\n                        P\n                        <jats:sub>Interaction<\/jats:sub>\n                      <\/jats:italic>\n                      \u00a0=\u00a00.05) were statistically meaningful. More pCRs were observed in patients with nodal-positive (OR, 1.89; 95% CI, 1.56-2.28;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001) or high-density sTIL tumors (OR, 2.89; 95% CI, 1.49-5.61;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001), but not in women with nodal-negative (OR, 1.05; 95% CI, 0.80-1.39;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.71) or low-density sTIL tumors (OR, 1.26; 95% CI, 0.73-2.17;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.41). There was insufficient evidence to support other characteristics, including race, age, PD-L1 expression, clinical stage, hormone receptor (HR) status, menopausal status, Eastern Cooperative Oncology Group (ECOG) performance status, and T stage, as predictive biomarkers to guide patient selection for neoadjuvant immunotherapy in breast cancer.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Neoadjuvant immunotherapy was associated with favorable outcomes in breast cancer. However, for patients with HER2+, nodal-negative, or low-density sTIL tumors, clinicians need to carefully balance efficacy, safety, and patient preferences to deliver individualized treatment. Further randomized trials with long-term outcomes are needed to confirm the predictive values of these biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261307112<\/jats:ext-link>\n                      , identifier PROSPERO CRD420261307112.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1771228","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T06:36:58Z","timestamp":1774593418000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinicopathological and molecular characteristics associated with pathological complete response in neoadjuvant immunotherapy for breast 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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinfeng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Quanzhou First Hospital Affiliated to Fujian Medical University","place":["Quanzhou, China"]},{"name":"Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjie","family":"Cai","sequence":"additional","affiliation":[{"name":"Quanzhou First Hospital Affiliated to Fujian Medical University","place":["Quanzhou, China"]},{"name":"Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Quanzhou First Hospital Affiliated to Fujian Medical University","place":["Quanzhou, China"]},{"name":"Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, 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