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

Abstract

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.