Potential Value of Neoadjuvant Immunochemotherapy in Patients with Driver Gene-positive Non-small Cell Lung Cancer
10.3779/j.issn.1009-3419.2024.101.24
- VernacularTitle:新辅助免疫联合化疗在驱动基因阳性非小细胞肺癌患者中的潜在应用价值
- Author:
WEI ZIHAN
1
;
ZHOU YU
;
PU XINGXIANG
;
YAN XIANG
Author Information
1. 100871 北京,北京大学人民医院胸外科
- Keywords:
Lung neoplasms;
Neoadjuvant immunotherapy;
Diver gene mutation
- From:
Chinese Journal of Lung Cancer
2024;27(9):674-684
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective The proportion of patients carrying driver gene mutations is notably high among individuals with non-small cell lung cancer(NSCLC)in China.However,the current neoadjuvant treatment strategies for these patients lack evident benefits.This study aims to investigate the efficacy and adverse reactions of neoadjuvant immu-nochemotherapy in patients with driver gene-positive NSCLC,thereby exploring its potential therapeutic value.Methods A total of 50 patients from two centers were retrospectively collected to compare the efficacy and adverse reactions among driver gene-positive NSCLC patients after different treatments and further explore the response to neoadjuvant immunochemo-therapy among different EGFR-sensitive subtypes.Results A total of 50 patients from two centers were included in this study.Among the 40 patients from Peking University People's Hospital(PKUPH),21 received neoadjuvant immunotherapy,with 57.1％ showing partial response on imaging.The major pathological response(MPR)rate after neoadjuvant immunochemo-therapy was 38.1％ ,and pathological complete response(pCR)was only observed in this group.No significant differences were noted in adverse events or their impact on surgical difficulty among different treatments.Additionally,10 patients from Hunan Cancer Hospital(HNCA)were included to analyze the differences in efficiency among EGFR-sensitive subtypes under various neoadjuvant strategies.No significant radiological response differences were observed between neoadjuvant immunotherapy and targeted therapy.However,patients with the L858R mutation exhibited MPR and pCR only after receiving immuno-therapy,surpassing targeted therapy outcomes,while no significant differences were found among 19del patients.Conclusion Under the premise of not exacerbating adverse effects,neoadjuvant immunochemotherapy achieved superior rates of MPR and pCR,with long-term survival comparable to targeted therapy.
