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Lung Cancer Diagnosis and Treatment / Cancer, Stress, Anesthesia, and Immune Response · Journal article
BMC Cancer · September 8, 2026
Well-designed and adequately powered for the question it asks.
This meta-analysis of 8 RCTs involving 5,123 patients with resectable NSCLC quantifies the time to benefit of perioperative immunotherapy using Weibull survival modelling. Near-linear accumulation of benefit was observed, with 9–10 months of therapy required to achieve clinically meaningful (10%) absolute risk reduction in event-free and overall survival, though benefit accrues incrementally from month 1.
Meta-analysis of randomized controlled trials with reconstructed individual patient data. Patients with resectable non-small-cell lung cancer from eight randomized controlled trials of perioperative immunotherapy.. Intervention: Perioperative immunotherapy (type and agents not specified in abstract).. Compared with: Pooled control arms from constituent RCTs (likely surgery alone or standard chemotherapy; not explicitly stated in abstract).. n = 5,123.
1.02 months of perioperative immunotherapy required for 1% event-free survival risk reduction 9.01 months required for 10% event-free survival risk reduction 10.67 months required for 1% overall survival mortality risk reduction
10.67 months required for 1% overall survival mortality risk reduction
Clinicians may use these time-to-benefit estimates to counsel patients on expected duration of perioperative immunotherapy and to support individualized treatment planning. The finding that meaningful benefit (10% ARR) emerges by 9–10 months suggests a rational target duration, though subgroup variation indicates patient-specific factors merit consideration.
Rigorous meta-analysis of 8 RCTs with reconstructed individual patient data and quantitative time-to-benefit modelling provides robust evidence on treatment duration, though findings are primarily analytical rather than from a new primary trial.
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Quoted from the source exactly as published.
Clinicians may use these time-to-benefit estimates to counsel patients on expected duration of perioperative immunotherapy and to support individualized treatment planning. The finding that meaningful benefit (10% ARR) emerges by 9–10 months suggests a rational target duration, though subgroup variation indicates patient-specific factors merit consideration.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract Background The optimal duration of perioperative immunotherapy for resectable non–small-cell lung cancer (NSCLC) remains undefined, and conventional efficacy measures provide limited insight into the temporal pattern of benefit emergence, for which time-to-benefit (TTB) serves as a complementary metric that quantifies how therapeutic effects accumulate over time and bridges the gap between treatment duration and clinical benefit. This study aimed to quantitatively assess the TTB of perioperative immunotherapy and determine the treatment duration required to achieve predefined absolute risk reduction (ARR) thresholds. Methods This comparative effectiveness study reconstructed individual patient data from eight randomized controlled trials (RCTs) using digitized Kaplan-Meier curves. Pooled survival analyses and Weibull survival modeling with Monte Carlo simulation were applied to estimate TTB at ARR thresholds. Subgroup analyses were conducted by histology, stage, and PD-L1 expression. Results Among 5,123 participants, the entire perioperative immunotherapy significantly improved event-free survival (EFS) and overall survival (OS). TTB analysis showed a near-linear accumulation of benefit: 1.02 months of therapy were required for a 1% EFS-related risk reduction and 9.01 months for a 10% reduction. For OS, a 1% mortality risk reduction required 10.67 months. Subgroup analyses demonstrated that, for the same ARR thresholds, patients with squamous histology, stage III disease, or PD-L1 expression ≥ 1% achieved shorter TTB. Conclusions This study quantitatively evaluated TTB in perioperative immunotherapy for resectable NSCLC, revealing a near-linear accumulation of benefit with meaningful efficacy by 9–10 months, and establishing TTB as a complementary endpoint to guide evidence-based, individualized treatment duration optimization.
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