Comparison of different criteria for estimating major pathological response in resectable non-small cell lung cancer treated with neoadjuvant chemoimmunotherapy

IF 1.5 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology Pub Date : 2024-01-30 DOI:10.1016/j.anndiagpath.2024.152268

Wei Sun , Xinying Liu , Chenglong Wang, Yumeng Jiang, Dongmei Lin

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引用次数: 0

Abstract

Background

Major pathological response (MPR) is proposed as a surrogate endpoint for survival in non-small cell lung cancer (NSCLC) after neoadjuvant chemoimmunotherapy. However, the criteria for estimating MPR differ between the recommendations of the International Association for the Study of Lung Cancer (IASLC) and the immune-related pathologic response criterion (irPRC). IASLC's criteria focus solely on evaluating the primary tumor, while irPRC's criteria encompass both the primary tumor and lymph node metastasis. Our objective is to compare the prognostic value of different criteria for estimating MPR.

Methods

We conducted a retrospective study on a cohort of 235 patients with NSCLC after neoadjuvant chemoimmunotherapy. The survival endpoint was event-free survival (EFS). The MPR status of each patient was evaluated using both IASLC's criteria and irPRC's criteria. The prognostic value was compared using the Area Under Curve (AUC).

Results

The MPR rates were 63.4 % (149/235) and 57.4 % (135/235) according to IASLC's and irPRC's criteria, respectively. Inconsistent cases, characterized by MPR status according to IASLC's criteria but non-MPR status according to irPRC's criteria, constituted 6.0 % (14/235) of the overall cohort and 15.2 % (14/92) of patients with pretreatment N positive disease. Interestingly, all inconsistent patients showed no recurrence during the study period. Although both MPR statuses according to IASLC (p = 0.00039) and irPRC (p = 0.0094) were associated with improved EFS, IASLC's criteria (AUC = 0.65) were superior to irPRC's criteria (AUC = 0.62) with a higher AUC value.

Conclusion

IASLC's criteria for estimating MPR were superior to irPRC's criteria in predicting EFS for NSCLC after neoadjuvant chemoimmunotherapy.

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新辅助化疗免疫疗法治疗的可切除非小细胞肺癌主要病理反应不同评估标准的比较

背景重大病理反应（MPR）被认为是非小细胞肺癌（NSCLC）新辅助免疫化疗后生存率的替代终点。然而，国际肺癌研究协会（IASLC）和免疫相关病理反应标准（irPRC）的建议在估算 MPR 的标准上有所不同。IASLC 的标准只侧重于评估原发肿瘤，而 irPRC 的标准则包括原发肿瘤和淋巴结转移。我们的目的是比较不同标准在估计MPR方面的预后价值。方法我们对新辅助化疗免疫疗法后的235例NSCLC患者进行了一项回顾性研究。生存终点为无事件生存期（EFS）。采用IASLC标准和irPRC标准对每位患者的MPR状态进行评估。结果根据IASLC标准和irPRC标准，MPR率分别为63.4%（149/235）和57.4%（135/235）。不一致病例的特点是，根据 IASLC 的标准为 MPR 状态，但根据 irPRC 的标准为非 MPR 状态，占整个队列的 6.0%（14/235），占治疗前 N 阳性患者的 15.2%（14/92）。有趣的是，所有不一致的患者在研究期间都没有复发。虽然IASLC（p = 0.00039）和irPRC（p = 0.0094）的MPR状态都与EFS的改善有关，但IASLC的标准（AUC = 0.65）优于irPRC的标准（AUC = 0.62），且AUC值更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Diagnostic Pathology 医学-病理学

CiteScore

3.90

自引率

5.00%

发文量

149

审稿时长

26 days

期刊介绍： A peer-reviewed journal devoted to the publication of articles dealing with traditional morphologic studies using standard diagnostic techniques and stressing clinicopathological correlations and scientific observation of relevance to the daily practice of pathology. Special features include pathologic-radiologic correlations and pathologic-cytologic correlations.