Microwave Ablation Combined With Neoadjuvant Chemotherapy and Immunotherapy in Resectable Stage IIB-IIIB Non-Small Cell Lung Cancer: A Single-Center Retrospective Study.

Background: Chemotherapy combined with immunotherapy has emerged as a pivotal neoadjuvant strategy for resectable locally advanced non-small cell lung cancer (NSCLC). However, several problems urge to be resolved, including suboptimal pathologic complete response(pCR)/major pathologic response (MPR). Microwave ablation (MWA) exerts direct tumoricidal effects through thermal coagulation while releasing tumor-associated antigens to remodel the local immune microenvironment. In patients with advanced NSCLC, MWA combined with chemotherapy or immunotherapy has shown prolonged overall survival (OS).

Methods: This study investigated the neoadjuvant therapeutic strategy combining MWA with chemotherapy and immunotherapy for optimizing neoadjuvant treatment strategies of stage IIB-IIIB NSCLC. We evaluated the pCR, MPR, R0 resection rate, and incidence of grade ≥ 3 adverse events in patients following surgical resection, aiming to improve surgical outcomes and survival.

Results: This study confirmed the safety and feasibility of a neoadjuvant therapeutic strategy combining MWA with chemotherapy and immunotherapy in patients with NSCLC. The study was a single-center retrospective analysis (n = 8), demonstrating a pCR rate of 50%, an MPR rate of 62.5%, an R0 resection rate of 100%, with no increase in grade ≥ 3 adverse events.

Conclusions: In this retrospective analysis, the neoadjuvant therapeutic strategy combining MWA with chemotherapy and immunotherapy preliminarily demonstrates safety and feasibility in resectable stage IIB-IIIB NSCLC, while showing potential to improve pCR and MPR rates. Furthermore, the integration of MWA may propose a novel treatment approach for optimizing neoadjuvant therapy. Prospective multicenter clinical trials are required to further validate the safety and feasibility, as well as its impact on long-term survival benefits.