4.6 Article

Lung Cancer Surgery after Treatment with Anti-PD1/PD-L1 Immunotherapy for Non-Small-Cell Lung Cancer: A Case-Cohort Study

期刊

CANCERS
卷 13, 期 19, 页码 -

出版社

MDPI
DOI: 10.3390/cancers13194915

关键词

non-small-cell lung cancer; immune checkpoint inhibitors; immunotherapy; anti-PD1/PD-L1; lung resection; safety

类别

向作者/读者索取更多资源

This study confirms the safety of lung resection in patients following preoperative ICI treatment, with higher rates of major pathological response and disease-free survival in the ICI cohort. The study suggests that preoperative ICI treatment does not lead to higher perioperative morbidity or mortality.
Simple Summary The scope of indications for immune checkpoint inhibitors (ICIs) in non-small-cell lung cancer is growing, and an increasing number of patients are undergoing lung resection surgery after ICI treatment, with some technical difficulties being reported. The aim of our study was to determine if preoperative ICIs were associated with more difficult lung surgeries or poorer perioperative outcomes compared to surgeries performed after induction chemotherapy. We confirmed that ICIs were associated with tissue fibrosis and inflammation, particularly in centrally located lung tumours, although this did not translate to higher rates of perioperative morbidity. There was no 90-day mortality. We also found higher rates of major pathological response to pre-operative treatment in the ICI cohort and higher disease-free survival. Our findings further support the safety of lung resection in patients following preoperative ICIs. Background: Immune checkpoint inhibitors (ICIs) are the standard of care for non-resectable non-small-cell lung cancer and are under investigation for resectable disease. Some authors have reported difficulties during lung surgery following ICI treatment. This retrospective study investigated the perioperative outcomes of lung resection in patients with preoperative ICI. Methods: Patients with major lung resection after receiving ICIs were included as cases and were compared to patients who received preoperative chemotherapy without ICI. Surgical, clinical, and imaging data were collected. Results: A total of 25 patients were included in the ICI group, and 34 were included in the control group. The ICI patients received five (2-18) infusions of ICI (80% with pembrolizumab). Indications for surgery varied widely across groups (p < 0.01). Major pathological response was achieved in 44% of ICI patients and 23.5% of the control group (p = 0.049). Surgery reports showed a higher rate of tissue fibrosis/inflammation in the ICI group (p < 0.01), mostly in centrally located tumours (7/13, 53.8% vs. 3/11, 27.3% of distal tumours, p = 0.24), with no difference in operating time (p = 0.81) nor more conversions (p = 0.46) or perioperative complications (p = 0.94). There was no 90-day mortality. Disease-free survival was higher in the ICI group (HR = 0.30 (0.13-0.71), p = 0.02). Conclusions: This study further supports the safety and feasibility of lung resection in patients following preoperative treatment with ICI.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.6
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据