Efficacy of neoadjuvant immunochemotherapy in the treatment of stage III non-small-cell lung cancer with cancer driver gene mutations.

IF 4 2区医学 Q2 ONCOLOGY

Translational lung cancer research Pub Date : 2025-02-28 Epub Date: 2025-02-27 DOI:10.21037/tlcr-2025-60

Yuhong Yang, Jiacong Liu, Linhai Zhu, Xuhua Huang, Jiayue Ye, Nagashree Seetharamu, Hiroyuki Adachi, Jinming Xu, Yiqing Wang, Pinghui Xia, Wang Lv, Chong Zhang, Jian Hu

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引用次数: 0

Abstract

Background: Patients with non-small-cell lung cancer (NSCLC) and cancer driver gene mutations are mainly treated with targeted therapy. Research into the application of neoadjuvant immunochemotherapy for these patients is active and ongoing. In this study, we assessed the feasibility and safety of immunochemotherapy as a neoadjuvant treatment in patients with stage III NSCLC with common cancer driver gene mutations.

Methods: This retrospective study enrolled patients who had stage III NSCLC with the results of driver mutation testing [including epidermal growth factor receptor (EGFR), Kirsten rat sarcoma viral oncogene homolog (KRAS), c-ros proto-oncogene 1, receptor tyrosine kinase (ROS1), rearranged during transfection (RET), anaplastic lymphoma kinase (ALK), human epidermal growth factor receptor 2 (HER2), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA)] and received neoadjuvant immunochemotherapy. The patients were followed for at least 1 year after the operation or until the day the treatment was discontinued. The primary endpoints were objective response rate (ORR) and adverse events (AEs), while the secondary endpoints were pathological response among patients who undergo surgery, disease-free survival (DFS) and overall survival (OS).

Results: From 2020 to 2022, a total of 34 patients with stage III NSCLC were included in this study and were categorized into two groups according to the presence of cancer driver gene mutations: a mutation group (n=22) and a wild-type (WT) group (n=12). The rate of ORR in the WT group was 58.3%, and the rate of ORR in the mutation group was 68.2%. And no postoperative deaths or grade 3 or 4 AEs were observed in either of the groups. Among the patients who underwent surgery, the major pathological response (MPR) rate in the WT group and the mutation group was 75.0% and 47.0%, respectively (P=0.23). The pathological complete response (pCR) rate in the WT group and in the mutation group was 37.5% and 23.5%, respectively (P=0.64). The 1-year DFS rate in the WT group and the mutation group was 87.5% and 82.4%, respectively, while the 1-year OS rates in the WT group and the mutation group were both 100.0%.

Conclusions: The potential of neoadjuvant immunochemotherapy for patients with stage III NSCLC with cancer driver gene mutations is promising.

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新辅助免疫化疗治疗伴癌驱动基因突变的III期非小细胞肺癌的疗效

背景：非小细胞肺癌（NSCLC）和癌症驱动基因突变的患者主要采用靶向治疗。新辅助免疫化疗在这些患者中的应用研究正在积极进行中。在这项研究中，我们评估了免疫化疗作为具有常见癌症驱动基因突变的III期非小细胞肺癌患者的新辅助治疗的可行性和安全性。方法:本回顾性研究纳入了III期NSCLC患者，其驱动突变检测结果包括表皮生长因子受体（EGFR）、Kirsten大鼠肉瘤病毒癌基因同源物（KRAS）、c-ros原癌基因1、受体酪氨酸激酶（ROS1）、转染期间重排（RET）、间变性淋巴瘤激酶（ALK）、人表皮生长因子受体2 （HER2）、磷脂酰肌醇-4,5-二磷酸3-激酶催化亚基α (PIK3CA))]并接受新辅助免疫化疗。术后随访患者至少1年，或直至停止治疗。主要终点是客观缓解率（ORR）和不良事件（ae），次要终点是手术患者的病理反应、无病生存期（DFS）和总生存期（OS）。结果：2020 - 2022年共纳入34例III期NSCLC患者，根据是否存在癌驱动基因突变分为两组：突变组（n=22）和野生型（WT）组（n=12）。WT组的ORR为58.3%，突变组的ORR为68.2%。两组均无术后死亡或3级或4级不良事件发生。在手术患者中，WT组和突变组的主要病理反应（MPR）率分别为75.0%和47.0% （P=0.23）。WT组和突变组的病理完全缓解（pCR）率分别为37.5%和23.5% （P=0.64）。WT组和突变组的1年DFS率分别为87.5%和82.4%，而WT组和突变组的1年OS率均为100.0%。结论：新辅助免疫化疗对III期非小细胞肺癌驱动基因突变患者的治疗前景看好。

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

Translational lung cancer research Medicine-Oncology

CiteScore

7.20

自引率

2.50%

发文量

137

期刊介绍： Translational Lung Cancer Research(TLCR, Transl Lung Cancer Res, Print ISSN 2218-6751; Online ISSN 2226-4477) is an international, peer-reviewed, open-access journal, which was founded in March 2012. TLCR is indexed by PubMed/PubMed Central and the Chemical Abstracts Service (CAS) Databases. It is published quarterly the first year, and published bimonthly since February 2013. It provides practical up-to-date information on prevention, early detection, diagnosis, and treatment of lung cancer. Specific areas of its interest include, but not limited to, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to lung cancer.