{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:54:42Z","timestamp":1791266082356,"version":"4.1.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"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>Multiple RCTs have established PD-1\/PD-L1 inhibitors as standard in triple-negative breast cancer (TNBC), but prior meta-analyses lacked complete setting coverage, mature long-term survival data, and a quantification of chemotherapy-backbone impact\u2014critical given IMpassion130 (nab-paclitaxel, positive) vs. IMpassion131 (paclitaxel, negative). This update includes final KEYNOTE-522 OS, GeparNuevo 7-year follow-up, and TORCHLIGHT Phase III data, covering neoadjuvant to metastatic disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed and ClinicalTrials.gov to May 2026 plus conference proceedings; an Embase search found no additional trials. Included RCTs compared ICI + chemotherapy vs. chemotherapy alone in TNBC, stratified by setting. The primary endpoints are OS (metastatic) and EFS\/iDFS (early-stage). Pooled HRs used random-effects meta-analysis with HKSJ adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 10 RCTs (5,953 patients) met the inclusion. In the metastatic setting (five RCTs,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a03,526), ICI improved OS (HR 0.85, 95% CI 0.74\u20130.96; HKSJ-adjusted 0.70\u20131.03;\n                      <jats:italic>I<\/jats:italic>\n                      \u00b2 = 27%) and PFS (HR 0.82, 0.73\u20130.92;\n                      <jats:italic>I<\/jats:italic>\n                      \u00b2 = 35%); OS benefit was greater in PD-L1+ patients (HR 0.79, 0.65\u20130.95;\n                      <jats:italic>I<\/jats:italic>\n                      \u00b2 = 51%). Numerically greater OS with anti-PD-1 vs. anti-PD-L1 was not robust in the sensitivity analysis. In the early-stage setting (five RCTs,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a02,427), ICIs improved EFS\/iDFS (HR 0.75, 0.63\u20130.90;\n                      <jats:italic>I<\/jats:italic>\n                      \u00b2 = 0.2%) and OS (HR 0.64, 0.53\u20130.78;\n                      <jats:italic>I<\/jats:italic>\n                      \u00b2 = 0%) and increased pCR (OR 1.65, 1.39\u20131.98;\n                      <jats:italic>I<\/jats:italic>\n                      \u00b2 = 1%). HKSJ adjustment widened the Cis, but the effect patterns remained consistent.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This update confirms a consistent survival benefit of ICI + chemotherapy in both early and metastatic TNBC, which was most pronounced in PD-L1+ populations. Long-term data show durability, especially in neoadjuvant\/adjuvant settings. The divergent outcomes with nab-paclitaxel vs. paclitaxel underscore the critical role of the chemotherapy backbone. These findings support current guidelines and highlight the need for refined biomarkers to extend benefit to PD-L1-negative patients.<\/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\/display_record.php?ID=CRD420261356428<\/jats:ext-link>\n                      , identifier CRD420261356428.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1958007","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:21:03Z","timestamp":1791264063000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["PD-1\/PD-L1 inhibitors combined with chemotherapy or as monotherapy versus chemotherapy alone or observation in triple-negative breast cancer: a systematic review and updated meta-analysis incorporating long-term survival data"],"prefix":"10.3389","volume":"17","author":[{"given":"Bing","family":"Guan","sequence":"first","affiliation":[{"name":"Department of Pathology, Suzhou BenQ Medical Center","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Suzhou BenQ Medical Center","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pathology, Suzhou BenQ Medical Center","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sijia","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Suzhou BenQ Medical Center","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lulu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pathology, Suzhou BenQ Medical Center","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"He","sequence":"additional","affiliation":[{"name":"Department of Pathology, Suzhou BenQ Medical Center","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1001389","article-title":"Triple-negative breast cancer","volume":"363","author":"Foulkes","year":"2010","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-06-3045","article-title":"Triple-negative breast cancer: clinical features and patterns of 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