{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T06:02:37Z","timestamp":1780293757382,"version":"3.54.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"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>Objective<\/jats:title>\n                    <jats:p>To evaluate the efficacy and safety of programmed death-1\/programmed death-ligand 1 (PD-1\/PD-L1) inhibitors combined with chemotherapy as first-line treatment for advanced or metastatic endometrial cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was conducted in PubMed, Embase, Web of Science, the Cochrane Library, and ClinicalTrials.gov from inception to November 26, 2025. Meta-analyses were performed to pool outcomes including progression-free survival, overall survival, objective response rate, complete response, partial response, stable disease, progressive disease, and treatment-related adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ten randomized controlled trials encompassing 4,052 patients were included (combination arm: n=2,109; chemotherapy-alone arm: n=1,943). Compared with chemotherapy alone, the addition of PD-1\/PD-L1 inhibitors significantly prolonged median overall survival (43.7 vs. 29.1 months) and median progression-free survival (14.6 vs. 10.2 months). The relative risks (RR) for efficacy endpoints were as follows: complete response, 1.60 (95% CI: 1.25\u20132.05); partial response, 0.99 (95% CI: 0.88\u20131.12); stable disease, 0.68 (95% CI: 0.54\u20130.86); progressive disease, 0.69 (95% CI: 0.45\u20131.06); and objective response rate, 1.10 (95% CI: 1.02\u20131.18). The most common treatment-related adverse events were fatigue, alopecia, nausea, peripheral neuropathy, anemia, arthralgia, constipation, and diarrhea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combination of PD-1\/PD-L1 inhibitors and chemotherapy significantly improves progression-free survival and overall survival in patients with advanced or metastatic endometrial cancer, with the significant OS benefit in dMMR; PFS benefit but no OS benefit in pMMR.<\/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\/, identifier CRD420251271038<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  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