Neoadjuvant immune checkpoint inhibitor therapy in resectable non-small cell lung cancer

Conroy, Michael R.; Dennehy, Colum; Forde, Patrick M.

doi:10.1016/j.lungcan.2023.107314

Cited by 5 publications

(1 citation statement)

References 102 publications

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“…Likewise, there remains a small chance that delayed surgery, due to initial administration of systemic therapy, causes some patients to become inoperable, either due to tumor progression or patient deterioration, but this seems to be a rare event. 9 Pathological response, measured as the percentage of residual viable tumor (RVT) in the resected lung, is currently used as a surrogate end point for many clinical studies. MPR, defined as ≤ 10% RVT, has been established as a surrogate end point for OS after neoadjuvant chemotherapy, potentially improving the efficiency of trials and expediting scientific advances.…”

Section: Introduction and Clinical Rationale Behind Neoadjuvant Therapymentioning

confidence: 99%

Pathology of Surgically Resected Lung Cancers Following Neoadjuvant Therapy

Berezowska,

Keyter,

Bouchaab

et al. 2024

Advances in Anatomic Pathology

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In around 30% of patients, non-small cell lung cancer is diagnosed at an advanced but resectable stage. Adding systemic therapy has shown clear benefit over surgery alone in locally advanced disease, and currently, chemo-immunotherapy in the adjuvant or neoadjuvant setting is the new standard for patients without targetable mutations. One major advantage of the neoadjuvant approach is the possibility of an immediate evaluation of the treatment effect, highlighting the role of pathology as an important contributor at the forefront of clinical decision-making and research. This review provides a summary and an update on current guidelines for histological evaluation of treatment effect after neoadjuvant therapy, also known as regression grading, and discusses newer data focusing on areas of evolving questions and controversies, such as the gross examination of the tumor and tumor bed, weighted versus unweighted evaluation approaches, discussion of histologic tumor type-specific cut-offs for major pathologic response, assessment of lymph nodes and regression grading after immunotherapy and targeted therapy. As no data or recommendations exist on regression grading of multiple tumor nodules, a practical approach is recommended. Lastly, we will touch on additional tissue biomarkers and summarize recent advances in the ardently discussed field of using circulating tumor DNA for the evaluation of treatment response.

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Section: Introduction and Clinical Rationale Behind Neoadjuvant Therapymentioning

confidence: 99%