Real-world long-term outcomes of non-small cell lung cancer patients undergoing neoadjuvant treatment with or without immune checkpoint inhibitors.
10.1097/CM9.0000000000003551
- Author:
Bolun ZHOU
1
;
Lin LI
2
;
Fan ZHANG
3
;
Qilin HUAI
4
;
Liang ZHAO
1
;
Fengwei TAN
1
;
Qi XUE
1
;
Wei GUO
3
;
Shugeng GAO
1
Author Information
1. Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
2. Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
3. Key Laboratory of Minimally Invasive Therapy Research for Lung Cancer, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
4. Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong First Medical University, Shandong First Medical University, Jinan, Shandong 250021, China.
- Publication Type:Journal Article
- Keywords:
Immune checkpoint inhibitor;
Neoadjuvant immunotherapy;
Neoadjuvant therapy;
Non-small cell lung cancer;
Prognosis
- MeSH:
Humans;
Carcinoma, Non-Small-Cell Lung/mortality*;
Male;
Female;
Lung Neoplasms/mortality*;
Middle Aged;
Immune Checkpoint Inhibitors/therapeutic use*;
Neoadjuvant Therapy/methods*;
Retrospective Studies;
Aged;
Adult;
Kaplan-Meier Estimate;
Treatment Outcome;
Immunotherapy/methods*
- From:
Chinese Medical Journal
2025;138(22):2963-2973
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Immune checkpoint inhibitors (ICIs) have been included in various neoadjuvant therapy (NAT) regimens for non-small cell lung cancer (NSCLC). However, due to the relatively short period for the use of ICIs in NAT, patients' clinical outcomes with different regimens are uncertain. Our study aims to examine the efficacy of neoadjuvant immunotherapy (NAIT) for NSCLC patients and compare the overall survival (OS) and event-free survival (EFS) of patients receiving different NAT regimens.
METHODS:This study retrospectively included 308 NSCLC patients treated with different NAT regimens and subsequent surgery in National Cancer Center between August 1, 2016 and July 31, 2022. Kaplan-Meier survival analysis and Cox proportional hazards regression analysis were conducted to evaluate the prognosis of patients.
RESULTS:With a median follow-up of 27.5 months, the 1-year OS rates were 98.8% and 96.2%, and the 2-year OS rates were 96.6% and 85.8% in patients of the NAIT and neoadjuvant chemotherapy (NACT) group, respectively (hazard ratio [HR], 0.339; 95% confidence interval [CI], 0.160-0.720; P = 0.003). The 1-year EFS rates were 96.0% and 88.0%, and the 2-year EFS rates were 92.0% and 77.7% for patients in the NAIT and NACT groups, respectively (HR, 0.438; 95% CI, 0.276-0.846; P = 0.010). For patients who did not achieve pathological complete response (pCR), significantly longer OS ( P = 0.012) and EFS ( P = 0.019) were observed in patients receiving NAIT than those receiving NACT. Different NAT regimens had little effect on surgery and the postoperative length of stay (6 [4, 7] days vs . 6 [4, 7] days, Z = -0.227, P = 0.820).
CONCLUSIONS:NAIT exhibited superior efficacy to NACT for NSCLC, resulting in longer OS and EFS. The OS and EFS benefits were also observed among patients in the NAIT group who did not achieve pCR.
