The importance of histology in patient selection for platinum-based neoadjuvant treatment in non-small cell lung cancer.

Background: This study aims to evaluate the prognostic factors for overall survival and progression-free survival in non-small cell lung cancer patients receiving platinum-based neoadjuvant therapy.

Methods: Between January 2008 and December 2022, a total of 163 patients with clinical Stages 2B, 3A, and 3B non-small cell lung cancer (148 males, 15 females; mean age: 59.5±7.8 years; range, 33 to 76 years) who underwent operation after neoadjuvant chemotherapy or chemoradiotherapy were retrospectively analyzed. The prognostic factors for overall survival and progression-free survival were evaluated.

Results: Higher major pathological response rate (p=0.021) and lower recurrence rate (p=0.009) were observed in patients with squamous cell carcinoma. The five-year progression-free survival rates were 56.9% and 34.1% for patients with squamous and non-squamous cell cancers (p=0.007) and the five-year overall survival rates were 68.2% and 52.2%, respectively (p=0.046). Squamous cell carcinoma histology was a favorable prognostic factor for both progression-free survival (p=0.008) and overall survival OS (p=0.031).

Conclusion: Tumor histology may serve as a prognostic factor, helping to predict patient outcomes and guide the selection of neoadjuvant therapies before surgery. Currently, platinum-based chemotherapies are still used as a standard. Clinicians should consider tumor histology while deciding on neoadjuvant treatment.