Efficacy and safety of neoadjuvant chemoimmunotherapy and chemotherapy in patients with potentially resectable stage IIIA/IIIB NSCLC: a retrospective study
BackgroundTreatment of locally advanced unresectable non-small cell lung cancer (NSCLC) is a significant challenge, especially for patients with IIIA/IIIB NSCLC. Patients receiving neoadjuvant chemoimmunotherapy (NCI) show improved pathological responses and disease-free survival (DFS) compared to t...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1479263/full |
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| author | Yuchen Wang Xiaobo Ma Kewei Ma Xi Chen Hua He Xiangye Zhao Mengge Fan Yinghui Xu |
| author_facet | Yuchen Wang Xiaobo Ma Kewei Ma Xi Chen Hua He Xiangye Zhao Mengge Fan Yinghui Xu |
| author_sort | Yuchen Wang |
| collection | DOAJ |
| description | BackgroundTreatment of locally advanced unresectable non-small cell lung cancer (NSCLC) is a significant challenge, especially for patients with IIIA/IIIB NSCLC. Patients receiving neoadjuvant chemoimmunotherapy (NCI) show improved pathological responses and disease-free survival (DFS) compared to those receiving Neoadjuvant chemotherapy (NC). However, there is still no consensus on the treatment for potentially resectable stage IIIA/IIIB NSCLC.MethodsThis retrospective study included 71 patients newly diagnosed with stage III NSCLC at our institution between 2017 and 2023: 46 patients received NCI and 25 patients received NC followed by surgical resection. Their clinicopathological characteristics were reviewed and analyzed.ResultsPatients who received NCI had a significantly longer DFS. The median DFS was 15 months in the NC group (hazard ratio: 0.186, 95% confidence interval[CI]: 0.073–0.479; P<0.001) but had not been reached in the NCI group. The percentage of patients achieving a major pathologic response was 65.9% (29/44, 95% CI: 50.0%–79.1%) with NCI and 16.7% (4/24, 95% CI: 5.5%–38.2%) with NC alone(P<0.001). The percentage of patients with pathologic complete response was 36.4% (16/44, 95% CI: 22.8%–52.3%) after NCI compared with 8.3% (2/24, 95% CI: 1.5%–28.5%) after NC (P = 0.012). The survival curve shows that the overall survival for the NCI group has a better trend than that of the NC group, but there is no significant difference (P=0.193). The incidence of all-grade adverse events was greater in the NCI group than in the NC group (80.4% vs. 64.0%). The incidence of grade ≥3 adverse events was 10.9% (n=5) and 8.0% (n=2), respectively; however, these differences were insignificant.ConclusionsNCI is more effective and safer for patients with potentially resectable stage IIIA/IIIB NSCLC. Compared with NC alone, NCI significantly improves the pathological response and DFS without increasing adverse events. |
| format | Article |
| id | doaj-art-cc54c5c2187d418386b9356ff41badf0 |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Frontiers in Immunology |
| spelling | doaj-art-cc54c5c2187d418386b9356ff41badf02025-01-17T06:50:43ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-01-011510.3389/fimmu.2024.14792631479263Efficacy and safety of neoadjuvant chemoimmunotherapy and chemotherapy in patients with potentially resectable stage IIIA/IIIB NSCLC: a retrospective studyYuchen Wang0Xiaobo Ma1Kewei Ma2Xi Chen3Hua He4Xiangye Zhao5Mengge Fan6Yinghui Xu7Cancer Center, The First Hospital of Jilin University, Changchun, Jilin, ChinaPathological Department, The First Hospital of Jilin University, Changchun, Jilin, ChinaCancer Center, The First Hospital of Jilin University, Changchun, Jilin, ChinaCancer Center, The First Hospital of Jilin University, Changchun, Jilin, ChinaCancer Center, The First Hospital of Jilin University, Changchun, Jilin, ChinaCancer Center, The First Hospital of Jilin University, Changchun, Jilin, ChinaCancer Center, The First Hospital of Jilin University, Changchun, Jilin, ChinaCancer Center, The First Hospital of Jilin University, Changchun, Jilin, ChinaBackgroundTreatment of locally advanced unresectable non-small cell lung cancer (NSCLC) is a significant challenge, especially for patients with IIIA/IIIB NSCLC. Patients receiving neoadjuvant chemoimmunotherapy (NCI) show improved pathological responses and disease-free survival (DFS) compared to those receiving Neoadjuvant chemotherapy (NC). However, there is still no consensus on the treatment for potentially resectable stage IIIA/IIIB NSCLC.MethodsThis retrospective study included 71 patients newly diagnosed with stage III NSCLC at our institution between 2017 and 2023: 46 patients received NCI and 25 patients received NC followed by surgical resection. Their clinicopathological characteristics were reviewed and analyzed.ResultsPatients who received NCI had a significantly longer DFS. The median DFS was 15 months in the NC group (hazard ratio: 0.186, 95% confidence interval[CI]: 0.073–0.479; P<0.001) but had not been reached in the NCI group. The percentage of patients achieving a major pathologic response was 65.9% (29/44, 95% CI: 50.0%–79.1%) with NCI and 16.7% (4/24, 95% CI: 5.5%–38.2%) with NC alone(P<0.001). The percentage of patients with pathologic complete response was 36.4% (16/44, 95% CI: 22.8%–52.3%) after NCI compared with 8.3% (2/24, 95% CI: 1.5%–28.5%) after NC (P = 0.012). The survival curve shows that the overall survival for the NCI group has a better trend than that of the NC group, but there is no significant difference (P=0.193). The incidence of all-grade adverse events was greater in the NCI group than in the NC group (80.4% vs. 64.0%). The incidence of grade ≥3 adverse events was 10.9% (n=5) and 8.0% (n=2), respectively; however, these differences were insignificant.ConclusionsNCI is more effective and safer for patients with potentially resectable stage IIIA/IIIB NSCLC. Compared with NC alone, NCI significantly improves the pathological response and DFS without increasing adverse events.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1479263/fullnon-small cell lung cancerneoadjuvant therapychemoimmunotherapypotentially resectableadverse events |
| spellingShingle | Yuchen Wang Xiaobo Ma Kewei Ma Xi Chen Hua He Xiangye Zhao Mengge Fan Yinghui Xu Efficacy and safety of neoadjuvant chemoimmunotherapy and chemotherapy in patients with potentially resectable stage IIIA/IIIB NSCLC: a retrospective study Frontiers in Immunology non-small cell lung cancer neoadjuvant therapy chemoimmunotherapy potentially resectable adverse events |
| title | Efficacy and safety of neoadjuvant chemoimmunotherapy and chemotherapy in patients with potentially resectable stage IIIA/IIIB NSCLC: a retrospective study |
| title_full | Efficacy and safety of neoadjuvant chemoimmunotherapy and chemotherapy in patients with potentially resectable stage IIIA/IIIB NSCLC: a retrospective study |
| title_fullStr | Efficacy and safety of neoadjuvant chemoimmunotherapy and chemotherapy in patients with potentially resectable stage IIIA/IIIB NSCLC: a retrospective study |
| title_full_unstemmed | Efficacy and safety of neoadjuvant chemoimmunotherapy and chemotherapy in patients with potentially resectable stage IIIA/IIIB NSCLC: a retrospective study |
| title_short | Efficacy and safety of neoadjuvant chemoimmunotherapy and chemotherapy in patients with potentially resectable stage IIIA/IIIB NSCLC: a retrospective study |
| title_sort | efficacy and safety of neoadjuvant chemoimmunotherapy and chemotherapy in patients with potentially resectable stage iiia iiib nsclc a retrospective study |
| topic | non-small cell lung cancer neoadjuvant therapy chemoimmunotherapy potentially resectable adverse events |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1479263/full |
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