Comparison of neoadjuvant chemoimmunotherapy with planned surgery and concurrent chemoradiation followed by immunotherapy for potentially resectable stage III non-small-cell lung cancer: a retrospective study.

IF 5.1 2区 医学 Q2 IMMUNOLOGY Cancer Immunology, Immunotherapy Pub Date : 2025-02-25 DOI:10.1007/s00262-025-03961-0
Yana Qi, Xiaoyang Zhai, Qinhao Xu, Yuqin Jin, Yingfan Guo, Miaoqing Zhao, Hui Zhu, Hongbo Guo
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Abstract

Objective: Despite the promising potential of neoadjuvant chemoimmunotherapy for non-small cell lung cancer (NSCLC), there is limited consensus on the optimal treatment strategy for potentially resectable NSCLC. This study aimed to evaluate the efficacy and safety of neoadjuvant chemoimmunotherapy (neoCT/IO) with planned surgery versus definitive concurrent chemoradiation followed by immunotherapy (cCRT + IO) in potentially resectable stage III NSCLC.

Methods: This retrospective study analyzed data from patients with potentially resectable stage III NSCLC who underwent neoCT/IO with planned surgery or cCRT + IO between March 2020 and June 2023. Propensity score matching (PSM) was used to balance heterogeneity between groups. Efficacy outcomes, safety profiles and patterns of disease recurrence were assessed.

Results: A total of 308 eligible patients were included in this study, of whom 195 (63.3%) underwent neoCT/IO and 113 (36.7%) received cCRT + IO. The neoCT/IO group consisted of patients who underwent neoCT/IO + Surgery and neoCT/IO + Radiotherapy. After 1:1 PSM, each group consisted of 105 patients. The median progression-free survival (PFS) was 25.9 months in the cCRT + IO group and not reached (NR) in the neoCT/IO group (hazard ratio: 2.91, 95% confidence interval: 1.77-4.78; p < 0.001). Median overall survival (OS) was NR in either group, with 3-year OS rates of 87.5% in the neoCT/IO group and 75.0% in the cCRT + IO group (p = 0.22). The incidence of grade 3/4 treatment-related adverse events was similar in both groups, except for a higher incidence of grade 3/4 hematological toxicity in the cCRT + IO group.

Conclusions: For patients with potentially resectable stage III NSCLC, neoCT/IO appears to be a safe approach and may offer better survival outcomes compared with cCRT + IO. Prospective randomized trials are needed to further validate these findings.

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对可能切除的III期非小细胞肺癌,新辅助化疗免疫治疗与计划手术和同步放化疗后免疫治疗的比较:一项回顾性研究。
目的:尽管新辅助化疗免疫治疗非小细胞肺癌(NSCLC)的潜力很大,但对于可能可切除的非小细胞肺癌的最佳治疗策略,人们的共识有限。本研究旨在评估计划手术的新辅助化疗免疫治疗(neoCT/IO)与确定同步放化疗后免疫治疗(cCRT + IO)在潜在可切除的III期NSCLC中的疗效和安全性。方法:本回顾性研究分析了2020年3月至2023年6月期间接受neoCT/IO计划手术或cCRT + IO的可能可切除的III期NSCLC患者的数据。倾向得分匹配(PSM)用于平衡组间异质性。评估了疗效、结果、安全性和疾病复发模式。结果:本研究共纳入308例符合条件的患者,其中195例(63.3%)接受了neoCT/IO, 113例(36.7%)接受了cCRT + IO。neoCT/IO组由接受neoCT/IO +手术和neoCT/IO +放疗的患者组成。经1:1 PSM后,每组105例。cCRT + IO组的中位无进展生存期(PFS)为25.9个月,neoCT/IO组未达到(NR)(风险比:2.91,95%可信区间:1.77-4.78;结论:对于可能可切除的III期NSCLC患者,neoCT/IO似乎是一种安全的方法,与cCRT + IO相比,可能提供更好的生存结果。需要前瞻性随机试验来进一步验证这些发现。
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来源期刊
CiteScore
10.50
自引率
1.70%
发文量
207
审稿时长
1 months
期刊介绍: Cancer Immunology, Immunotherapy has the basic aim of keeping readers informed of the latest research results in the fields of oncology and immunology. As knowledge expands, the scope of the journal has broadened to include more of the progress being made in the areas of biology concerned with biological response modifiers. This helps keep readers up to date on the latest advances in our understanding of tumor-host interactions. The journal publishes short editorials including "position papers," general reviews, original articles, and short communications, providing a forum for the most current experimental and clinical advances in tumor immunology.
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