Journal
FRONTIERS IN IMMUNOLOGY
Volume 13, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2022.938269
Keywords
operable locally advanced NSCLC; neoadjuvant therapy; major pathological response; tumor regression rate; clinical trial
Categories
Funding
- Technology Transfer Project of Shanghai Jiao Tong University School of Medicine [ZT202010]
- National Natural Science Foundation of China [82030045, 81972187]
- Projects of the Committee of Shanghai Science and Technology [19ZR1449800, 20Y11913700]
- Projects of Shanghai Municipal Public Health Bureau [201840122, 2019SY048]
- Doctoral Innovation Fund of Shanghai Jiao Tong University School of Medicine [BXJ201952]
- Interdisciplinary Program of Shanghai Jiao Tong University [YG2017MS80]
- Project of Shanghai Talent Development Fund [2019074]
- National Multi-disciplinary Treatment Project for Major Diseases [2020NMDTP]
- Technology Innovation Program of Shanghai [19411950500]
- National Key R&D Program of China [2016YFC1303300]
Ask authors/readers for more resources
This study compared the efficacy of different neoadjuvant therapies in operable locally advanced non-small cell lung cancer. It found that neoadjuvant immunotherapy achieved better pathologic complete response and had a superior combined curative effect compared to neoadjuvant chemotherapy and neoadjuvant targeted therapy.
BackgroundAn open, observational, three-arm clinical study aimed at investigating the efficacy of different neoadjuvant therapies (neoadjuvant immunotherapy with(out) chemotherapy, neoadjuvant chemotherapy, and neoadjuvant targeted therapy) in operable locally advanced non-small cell lung cancer (NSCLC) was conducted (NCT04197076). We report an interim analysis of 49 of 53 evaluable patients. MethodsThis study was conducted at Shanghai Chest Hospital and included eligible NSCLC patients who were 18 years old and had clinical stage IIB-IIIB disease. All 49 patients had surgical resection within 4-6 weeks after 2-3 cycles of neoadjuvant treatment consisting of immunotherapy (24 patients), chemotherapy (16 patients), and a targeted therapy (9 patients) regimen starting on the first day of each 21-day cycle. Pathologic complete response (pCR) was evaluated as the primary endpoint. Major pathological response (MPR) and tumor regression rate (TRR) were also evaluated. ResultsAn improved pathologic complete response was achieved in the neoadjuvant immunotherapy arm compared with the neoadjuvant chemotherapy arm and neoadjuvant targeted therapy arm [20.8% (5/24) vs. 6.3% (1/16) vs. 0.0% (0/9); P = 0.089, 95% CI 0.138-0.151]. More importantly, we found that the curative effect of the neoadjuvant immunotherapy arm in pCR+MPR was better than that of the neoadjuvant chemotherapy arm and neoadjuvant targeted therapy arm [45.8% (11/24) vs. 18.8% (3/16) vs. 0.0% (0/9); P = 0.006, 95% confidence interval, 0.008-0.012]. Different neoadjuvant therapies had a statistically significant effect on postoperative pathological tumor downstaging (P = 0.017). ConclusionsNeoadjuvant immunotherapy was associated with a trend toward better pCR than the neoadjuvant chemotherapy arm and neoadjuvant targeted therapy. Curative effect (pCR + MPR) was significantly better with neoadjuvant immunotherapy (P = 0.006, 95% confidence interval, 0.008-0.012).
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available