Analysis of operability parameter changes in neoadjuvant treatment with chemotherapy and anti-PD-1/PD-L1
Background: The adoption of combined chemotherapy (CT) and immunotherapy (IO) has advanced neoadjuvant therapy (NA) for non-small cell lung cancer (NSCLC), but data on functional impacts are limited. This multicenter retrospective study evaluates respiratory function in NSCLC patients undergoing NA....
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
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| Series: | Cancer Treatment and Research Communications |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468294225000474 |
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| Summary: | Background: The adoption of combined chemotherapy (CT) and immunotherapy (IO) has advanced neoadjuvant therapy (NA) for non-small cell lung cancer (NSCLC), but data on functional impacts are limited. This multicenter retrospective study evaluates respiratory function in NSCLC patients undergoing NA. Methods: From 2020 to 2024, 186 patients treated with CT or CT-IO (anti-PD-1/PD-L1) were analyzed. Respiratory tests (DLCO, FEV1, FVC) pre- and post-NA were compared, alongside clinical, pathological, and surgical variables. Results: Median age: 68; 66.6 % male; 93 % smokers/ex-smokers, histologies: Squamous and adenocarcinoma (46 % each), DLCO decline was greater in CT-IO vs. CT (-12.6 % vs. -7.8 %, p = 0.007) and CT-IO showed increased FEV1 (+3.8 % vs. -2.5 %, p = 0.001) and FVC (+3.7 % vs. -0.7 %, p = 0.003), surgery rate: 85.7 % (lobectomy most common at 83.3 %) and no differences in complications were found except for 9 immune-mediated events in CT-IO. Conclusions: CT-IO impacts DLCO more but improves FEV1 and FVC compared to CT. These findings warrant further validation in prospective studies. |
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| ISSN: | 2468-2942 |