Neoadjuvant immunotherapy combined with chemotherapy significantly improved patients’ overall survival when compared with neoadjuvant chemotherapy in non-small cell lung cancer: A cohort study

Dai, Fuqiang; Wu, Xiaoli; Wang, Xintian; Li, Kunkun; Wang, Yingjian; Shen, Cheng; Zhou, Jinhua; Niu, Huijun; Deng, Bo; Tan, Qunyou; Wang, Ruwen; Guo, Wei

doi:10.3389/fonc.2022.1022123

Cited by 12 publications

(7 citation statements)

References 45 publications

(50 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a retrospective study, patients who achieved pCR had better OS and DFS [34] and this conclusion was also been proved in Checkmate 816 [20]. However in our study, pCR was not associated with better EFS, and NADIM confirmed the same conclusion [30].…”

Section: Discussionsupporting

confidence: 78%

Three years follow-up of neoadjuvant chemoimmunotherapy in resectable non-small cell lung cancer

Ji,

Jiang,

et al. 2024

neo

View full text Add to dashboard Cite

Neoadjuvant chemoimmunotherapy plays a crucial role in resectable non-small cell lung cancer (NSCLC). Neoadjuvant chemotherapy before sleeve lobectomy was safe and feasible, but the impact of neoadjuvant chemoimmunotherapy before sleeve lobectomy was unclear. In our retrospective study, patients diagnosed as stage IIB to IIIB resectable NSCLC between December 1, 2018 and December 1, 2020 in the Department of Thoracic Surgery, Zhejiang Cancer Hospital were collected. We analyzed the efficacy and safety of neoadjuvant chemoimmunotherapy for resectable NSCLC patients and analyzed the impact of different types of surgery on postoperative complications, surgical difficulty, and long-term survival. In total, 56 patients were included in this retrospective study. With a median follow-up of 35 months, 1-year EFS, 2-year EFS, and 3-year EFS were 87.5%, 80.4%, and 76.7%, respectively. 1-year OS, 2-year OS, and 3-year OS were 96.4%, 91.1%, and 85.6%. respectively. Both median EFS and OS were not reached. The percentage of patients with pCR was 51.8%. 48 (85.7%) patients had nodal downstaging and primary tumor downstaging. In 40 (61.4%) patients occurred neoadjuvant chemoimmunotherapyrelated adverse events (AEs), most of them of Grade 1 and 2. Postoperative complications occurred in 19 (33.9%) patients. Subgroup analysis showed that sleeve lobectomy was related to better survival and had no impact on operation duration, hospital stay, intraoperative blood loss, and postoperative complications. Neoadjuvant chemoimmunotherapy led to a high pCR rate, favorable 3-year survival rate, and acceptable AEs. Sleeve lobectomy was safe and related to better survival.

show abstract

Section: Discussionsupporting

confidence: 78%

Three years follow-up of neoadjuvant chemoimmunotherapy in resectable non-small cell lung cancer

Ji,

Jiang,

et al. 2024

neo

View full text Add to dashboard Cite

show abstract

“…Recently, Zhang et al 18 conducted a retrospective study among stage IB-IIIB lung cancer patients and found that VATS achieved comparable efficacy to open surgery, with shorter ICU stays for patients, indicating the safety, efficacy, and feasibility of VATS as a surgical strategy for patients after immunotherapy. 19 Our results similarly demonstrated that patients who underwent MIS after immunotherapy had equally favorable prognoses to those who underwent thoracotomy. MIS not only maintained a clear field of vision for lymph node dissection but also offered advantages such as shorter operation times, less intraoperative blood loss, and fewer postoperative complications.…”

Section: Discussionsupporting

confidence: 74%

“…While several articles have mentioned the use of MIS in the surgical treatment of lung cancer patients after immunotherapy, 16,17 reports directly comparing MIS with thoracotomy have been limited. Recently, Zhang et al 18 conducted a retrospective study among stage IB–IIIB lung cancer patients and found that VATS achieved comparable efficacy to open surgery, with shorter ICU stays for patients, indicating the safety, efficacy, and feasibility of VATS as a surgical strategy for patients after immunotherapy 19 . Our results similarly demonstrated that patients who underwent MIS after immunotherapy had equally favorable prognoses to those who underwent thoracotomy.…”

Section: Discussionsupporting

confidence: 71%

“…mL vs. 120 [75, 200] mL, p < 0.001, Figure 5b) than lobectomy. Although extended resection achieved more lymph node removal (16 [12,19] vs. 10 [5, 13.5], p < 0.001, Figure 5c), it may also mean more postoperative complications (33.3% vs 11.6%, p = 0.012 Figure 5e) and a longer hospital stay (6 [5,9] days vs. 5 [4,6] days, p = 0.01, Figure 5d). In addition, patients may not benefit more from the surgical strategy of extended resection according to the result of PFS and OS (p = 0.52 and 0.85, respectively, Figure 5f,g).…”

Section: Survival Analysis In Patients With Complete Responsementioning

confidence: 99%

See 1 more Smart Citation

Subsequent surgical treatment or maintenance immunotherapy in stage III lung cancer patients achieving a favorable response following neoadjuvant immunotherapy: A matched retrospective cohort study from the surgical perspective

Dai,

Chen,

Zhou

et al. 2024

Thoracic Cancer

Self Cite

View full text Add to dashboard Cite

BackgroundCurrent treatment strategies for advanced non‐small cell lung cancer (NSCLC) are highly individualized and subject to ongoing debates. In the era of immunotherapy, surgery assumes a critical role. The aim of this study was to investigate if subsequent surgical intervention, following a favorable response to immunotherapy and chemotherapy, could yield a more favorable prognosis for patients with advanced stage III NSCLC compared to the continuation of immunotherapy and chemotherapy.MethodsWe included patients whose tumors exhibited a favorable response (including partial response [PR] and complete response [CR]) to immunotherapy and chemotherapy. These patients were categorized into two groups based on their subsequent treatment plans: surgical and nonsurgical (continuation of maintenance immunotherapy and chemotherapy). The efficacy and long‐term prognosis of these groups were compared after matching them in a 1:1 ratio using propensity scores.ResultsIn total, 186 patients (93 in each group) were included in this study after matching via propensity scores. The 1‐ and 3‐year overall survival (OS) and progression‐free survival (PFS) rates were 96.0%, 88.5%, and 93.1%, 80.7% in the surgical group, and 93.2%, 83.1%, and 57.7%, 50.4% in the nonsurgical group, respectively. Patients in the surgical group exhibited significantly superior PFS and OS compared to those in the nonsurgical group (p = 0.025 and p = 0.00086). Univariate and multivariate analyses confirmed ΔBMI, Δtumor size reduction, tumor response, earlier clinical stage (IIIb vs. IIIa), and surgery as independent protective factor for patient prognosis. We further selected 101 patients with CR (39 in the surgical group and 62 in the nonsurgical group) and found that patients in the surgical group were significantly better in both PFS and OS. Our subgroup analysis in postoperative patients demonstrated that different surgical strategies did not significantly affect the long‐term prognosis of patients (PFS and OS) but could impact their perioperative experience.ConclusionPatients with advanced stage III NSCLC, whose tumors achieved PR and CR after 2–4 cycles of immunotherapy combined with chemotherapy, experience a more promising prognosis with subsequent surgical intervention compared with the continued immunotherapy. Despite encountering formidable obstacles, such as protracted surgical procedures and associated trauma, we must rise to the challenge and unleash the power of surgery after immunotherapy in advanced NSCLC.

show abstract

“…In resectable NSCLC, major pathologic response (MPR) after neoadjuvant chemoimmunotherapy or chemotherapy was associated with better EFS and OS [23,24]. In our study, e cacy of induction therapy achieve PR patients had better PFS and OS than SD patients.…”

Section: Discussionmentioning

confidence: 54%

Short-term and long-term outcomes of induction chemoimmunotherapy before radical thoracic radiotherapy or chemoradiotherapy for unresectable stage III non-small cell lung cancer

Wang

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Consolidation therapy of durvalumab after concurrent chemoradiotherapy (cCRT) has been the standard of care for unresectable stage III non-small cell lung cancer (NSCLC). In this retrospective study, we assessed the safety and efficacy of induction chemoimmunotherapy in unresectable stage III NSCLC.Materials and method unresectable stage III NSCLC who received at least one cycle of induction chemoimmunotherapy and underwent radical thoracic radiotherapy (RT) were retrospectively collected. The impact of induction chemoimmunotherapy on unresectable stage III NSCLC was assessed.Results 72 patients were included, after induction chemoimmunotherapy, 51 (70.8%) patients received partial response (PR) and 21 (29.2%) received stable disease (SD). Grade 3 and 4 adverse events (AEs) related to induction chemoimmunotherapy were reported in 13 (18.1%) and four (5.6%) patients. Grade 3, 4 and 5 AEs related to cCRT or RT were reported in 18 (25.0%), 4 (5.6%) and 2 (2.8%) patients. 18 (25%) had radiation pneumonia, of which, seven (9.7%) were Grade 3, two (2.8%) were Grade 5. The median progression-free survival (PFS) and overall survival (OS) was 18 months (95%CI: 12.3–23.7) and 29 months (95%CI: 25.7–32.3). The efficacy of induction therapy achieved PR was an independent factor for better PFS and OS, ≥ 3 cycles of induction chemoimmunotherapy was an independent factor for better OS.Conclusion Induction chemoimmunotherapy was efficacy for unresectable stage III NSCLC. Radiation pneumonia should take into consideration. ≥ 3 cycles of induction chemoimmunotherapy and the efficacy of induction therapy achieved PR was associated with better survival.

show abstract

Neoadjuvant immunotherapy combined with chemotherapy significantly improved patients’ overall survival when compared with neoadjuvant chemotherapy in non-small cell lung cancer: A cohort study

Cited by 12 publications

References 45 publications

Three years follow-up of neoadjuvant chemoimmunotherapy in resectable non-small cell lung cancer

Three years follow-up of neoadjuvant chemoimmunotherapy in resectable non-small cell lung cancer

Subsequent surgical treatment or maintenance immunotherapy in stage III lung cancer patients achieving a favorable response following neoadjuvant immunotherapy: A matched retrospective cohort study from the surgical perspective

Short-term and long-term outcomes of induction chemoimmunotherapy before radical thoracic radiotherapy or chemoradiotherapy for unresectable stage III non-small cell lung cancer

Contact Info

Product

Resources

About