LBA5 A phase II study of neoadjuvant SHR-1701 with or without chemotherapy (chemo) followed by surgery or radiotherapy (RT) in stage III unresectable NSCLC (uNSCLC)

Wu, Y.-L.; Zhou, Q.; Pan, Y.; Yang, X.; Zhao, Y.; Han, G.; Pang, Q.; Zhang, Z.; Wang, Q.; Yao, J.; Wang, H.; Yang, W.; Liu, B.; Chen, Q.; Du, X.; Cai, K.; Li, B.; Shuang, J.; Song, L.; Shi, W.

doi:10.1016/j.iotech.2022.100361

Cited by 6 publications

(4 citation statements)

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“…However, to date, no phase III randomized trial has evaluated the application of immunotherapy in multimodal treatment regimens for patients with stage III NSCLC stratified by definitive treatment with surgery or CRT. Only a phase II trial conducted by Wu et al found that surgery after neoadjuvant chemoimmunotherapy appeared to be superior to definitive cCRT (1-year EFS 74.4% vs. 55.9%), but they focused on a highly selected population stratified by PD-L1 expression and followed by an MDT to determine subsequent treatment [ 12 ]. Considering that patients receiving definitive cCRT in this study accounted for only 1/3 of patients receiving CRT, the application of definitive cCRT and radical surgery after neoadjuvant chemoimmunotherapy was further investigated.…”

Section: Discussionmentioning

confidence: 99%

“…However, the impressive efficacy of neoadjuvant immunotherapy leads to questions regarding the conversion of unresectable status to resectable status. Several studies have shown the promising outcomes of neoadjuvant chemoimmunotherapy followed by surgery in patients with unresectable stage III NSCLC [ 10 – 12 ], suggesting that post-conversion surgical resection may play a role in this scenario. Interestingly, with a deeper understanding of immunotherapy, robust evidence has shown that the function and integrity of tumor-draining lymph nodes (dLNs) appear to correlate with the efficacy of immunotherapy [ 13 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Chemoradiotherapy versus surgery after neoadjuvant chemoimmunotherapy in patients with stage III NSCLC: a real-world multicenter retrospective study

Guan,

Sun,

Wang

et al. 2024

Cancer Immunol Immunother

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Purpose The optimal treatment after neoadjuvant chemoimmunotherapy for patients with stage III non-small cell lung cancer (NSCLC) is unclear. This study aimed at comparing the efficacy and safety of chemoradiotherapy and surgery after neoadjuvant chemoimmunotherapy in stage III NSCLC. Materials and methods We conducted a real-world multicenter retrospective study on patients with stage III NSCLC who received surgery or chemoradiotherapy after neoadjuvant chemoimmunotherapy between October 2018 and December 2022. Progression-free survival (PFS) and overall survival (OS) were assessed from the initiation of neoadjuvant treatment and estimated by the Kaplan‒Meier method. Univariate and multivariate Cox regression models were used to examine potential prognostic factors. One-to-one propensity score matching (PSM) was used to further minimize confounding. Results A total of 239 eligible patients were enrolled, with 104 (43.5%) receiving surgery and 135 (56.5%) receiving CRT. After 1:1 PSM, 1- and 2-year PFS rates in patients receiving radical surgery (rSurgery group) vs. patients receiving definitive cCRT (dCCRT group) were 80.0% vs. 79.2% and 67.2% vs. 53.1%, respectively (P = 0.774). One- and 2-year OS rates were 97.5% vs. 97.4% and 87.3% vs. 89.9%, respectively (P = 0.558). Patients in the dCCRT group had a numerically lower incidence of distant metastases compared to those in the rSurgery group (42.9% vs. 70.6%, P = 0.119). The incidence of treatment-related adverse events was similar in both groups, except that the incidence of grade 3/4 hematological toxicity was significantly higher in the dCCRT group (30.0% vs. 10.0%, P = 0.025). Conclusion Following neoadjuvant chemoimmunotherapy, definitive concurrent chemoradiotherapy may achieve noninferior outcomes to radical surgery in stage III NSCLC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Chemoradiotherapy versus surgery after neoadjuvant chemoimmunotherapy in patients with stage III NSCLC: a real-world multicenter retrospective study

Guan,

Sun,

Wang

et al. 2024

Cancer Immunol Immunother

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“…The results showed that patients with stage IIIB NSCLC had OS rates of 35% and 27% at 5 and 10 years, respectively, with an mOS of 26 months; the OS rates were 41% and 29% in patients with stage IIIC NSCLC [41]. More recently, Wu et al [98] (NCT04580498) showed that 27 of 107 (25.2%) patients with multidisciplinary team-confirmed unresectable LA-NSCLC were successfully converted to resectable status after three cycles of PD-L1/transforming growth factor-β bispecific antibody induction therapy. The conversion rates were 37% for patients with stage IIIA disease, 44.4% for patients with stage IIIB disease, and 18.5% for patients with stage IIIC disease; all patients achieved R0 resection.…”

Section: Redefinition Of Unresectable La-nsclcmentioning

confidence: 99%

Management of locally advanced non‐small cell lung cancer: State of the art and future directions

Miao,

Zhao,

Han

et al. 2023

Cancer Communications

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Lung cancer is the second most common and the deadliest type of cancer worldwide. Clinically, non‐small cell lung cancer (NSCLC) is the most common pathological type of lung cancer; approximately one‐third of affected patients have locally advanced NSCLC (LA‐NSCLC, stage III NSCLC) at diagnosis. Because of its heterogeneity, LA‐NSCLC often requires multidisciplinary assessment. Moreover, the prognosis of affected patients is much below satisfaction, and the efficacy of traditional therapeutic strategies has reached a plateau. With the emergence of targeted therapies and immunotherapies, as well as the continuous development of novel radiotherapies, we have entered an era of novel treatment paradigm for LA‐NSCLC. Here, we reviewed the landscape of relevant therapeutic modalities, including adjuvant, neoadjuvant, and perioperative targeted and immune strategies in patients with resectable LA‐NSCLC with/without oncogenic alterations; as well as novel combinations of chemoradiation and immunotherapy/targeted therapy in unresectable LA‐NSCLC. We addressed the unresolved challenges that remain in the field, and examined future directions to optimize clinical management and increase the cure rate of LA‐NSCLC.

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“…A phase II study evaluated neoadjuvant SHR-1701 with or without chemotherapy for three cycles, followed by surgery or radiotherapy in stage III NSCLC patients. SHR-1701 ± chemotherapy demonstrated encouraging anti-tumor activity with the best ORR of 70.1%, an event-free survival (EFS) of 18.2 months, and a tolerable safety profile [81].…”

Section: Bintrafusp Alfa (M7824)mentioning

confidence: 99%

Bispecific Antibodies in Lung Cancer: A State-of-the-Art Review

Khosla,

Jatwani,

Singh

et al. 2023

Pharmaceuticals

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Bispecific antibodies have emerged as a promising class of therapeutics in the field of oncology, offering an innovative approach to target cancer cells while sparing healthy tissues. These antibodies are designed to bind two different antigens, enabling them to bridge immune cells with cancer cells, resulting in enhanced tumor cell killing and improved treatment responses. This review article summarizes the current landscape of bispecific antibodies in lung cancer, including their mechanisms of action, clinical development, and potential applications in other solid tumor malignancies. Additionally, the challenges and opportunities associated with their use in the clinic are discussed, along with future directions for research and development in this exciting area of cancer immunotherapy.

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LBA5 A phase II study of neoadjuvant SHR-1701 with or without chemotherapy (chemo) followed by surgery or radiotherapy (RT) in stage III unresectable NSCLC (uNSCLC)

Cited by 6 publications

References 0 publications

Chemoradiotherapy versus surgery after neoadjuvant chemoimmunotherapy in patients with stage III NSCLC: a real-world multicenter retrospective study

Chemoradiotherapy versus surgery after neoadjuvant chemoimmunotherapy in patients with stage III NSCLC: a real-world multicenter retrospective study

Management of locally advanced non‐small cell lung cancer: State of the art and future directions

Bispecific Antibodies in Lung Cancer: A State-of-the-Art Review

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