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Paper

When immunotherapy hurts: neoadjuvant PD-1 inhibitors increase opioid use after mastectomy with reconstruction.

New research · Anesthesiology

Breast cancer research and treatment · 1h

Cohort studyBreast cancer research and treatment· Aug 2026

When immunotherapy hurts: neoadjuvant PD-1 inhibitors increase opioid use after mastectomy with reconstruction.

Tyler P Shern, Victoria Chamberlain, Logan R Holt … Barbara L Smith

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Perioperative MedicineCohort studyQ1IF 3.5

Neoadjuvant PD-1 inhibitors linked to more opioid refills after mastectomy with reconstruction

When immunotherapy hurts: neoadjuvant PD-1 inhibitors increase opioid use after mastectomy with reconstruction.

Tyler P Shern … Barbara L Smith

Breast cancer research and treatment · Aug 2026

Purpose

This study evaluated the effect of PD-1-based neoadjuvant chemotherapy (neoadjuvant chemotherapy) on perioperative opioid use and pain outcomes following mastectomy with immediate reconstruction.

Methods

Were grouped by PD-1-based neoadjuvant chemotherapy (neoadjuvant chemotherapy + PD-1) versus neoadjuvant chemotherapy without PD-1 inhibitors (neoadjuvant chemotherapy).

n = 277 patients

Results

OR = 3.574

neoadjuvant PD-1 therapy raised the odds of needing an opioid refill

n = 277 patients

More results

Among 277 patients, 54 received neoadjuvant chemotherapy + PD-1 and 223 received neoadjuvant chemotherapy.

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Conclusion

Neoadjuvant PD-1 inhibitors were associated with increased perioperative opioid requirements. Clinicians should consider potential PD-1-related alterations in analgesic response when managing pain in this population.

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