Alissa J. Cooper MD, Edoardo Garbo MD, Andrea Arfe PhD, Michael Conroy MB, BCh, Bao, Narek Shaverdian MD, Matthew Bott MD, Teresa Gorria MD, Federica Pecci MD, Mihaela Aldea MD, PhD, Valsamo Anagnostou MD, PhD, Adam Schoenfeld MD, Daniel Gomez MD, MBA, Patrick M. Forde MBBCh, Mark M. Awad MD, PhD, David R. Jones MD, Biagio Ricciuti MD, PhD, Jamie E. Chaft MD
{"title":"非小细胞肺癌患者新辅助化疗免疫治疗的实际结果：手术、病理完全缓解和无事件生存的预测因素","authors":"Alissa J. Cooper MD, Edoardo Garbo MD, Andrea Arfe PhD, Michael Conroy MB, BCh, Bao, Narek Shaverdian MD, Matthew Bott MD, Teresa Gorria MD, Federica Pecci MD, Mihaela Aldea MD, PhD, Valsamo Anagnostou MD, PhD, Adam Schoenfeld MD, Daniel Gomez MD, MBA, Patrick M. Forde MBBCh, Mark M. Awad MD, PhD, David R. Jones MD, Biagio Ricciuti MD, PhD, Jamie E. Chaft MD","doi":"10.1002/cncr.70081","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Trials of neoadjuvant chemoimmunotherapy (chemoIO) have changed the standard of care for resectable nonsmall cell lung cancer (NSCLC). This study characterizes the outcomes of off-trial patients who received treatment with neoadjuvant chemoIO.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The authors analyzed records of patients with stage IB–III NSCLC who received neoadjuvant chemoIO with an intent to proceed to surgical resection at three US academic institutions. Clinical, demographic, and pathologic factors were incorporated in univariable and multivariable regression models to identify associations with outcomes (resection status, pathologic complete response [pCR], and subsequent event-free survival [EFS]) after standard-of-care neoadjuvant chemoIO.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Analyses included 115 patients, of whom 63% had stage III disease, 77% completed three cycles of chemoIO, and 78% underwent surgical resection. Ages older than 72 years versus 64 years and younger were associated with not proceeding to surgery in univariable (<i>p</i> = .006) and multivariable (<i>p</i> = .014) regression analyses. Nineteen patients (17%) had tumors with a pCR, and 34 (30%) had a major pathologic response. Positive programmed death-ligand 1 (PD-L1) expression (≥50%; vs. negative PD-L1 expression: odds ratio, 12.1; 95% confidence interval, 2.0–73.7; <i>p</i> = .007) and <i>KRAS</i> mutations (vs. wild-type <i>KRAS</i>: odds ratio, 3.9; 95% confidence interval, 1.07–14.4; <i>p</i> = .039) were associated with a higher probability of pCR in univariable analysis. The median event-free survival was not reached and did not differ among subgroups stratified by key clinical variables.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The results from this study confirm the trial experience of high pCR rates after neoadjuvant chemoIO. This supports the use of chemoIO irrespective of <i>KRAS</i> mutation status, PD-L1 expression, and histology, but suggests that this approach may be less suitable for older patients.</p>\n </section>\n </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 18","pages":""},"PeriodicalIF":5.1000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70081","citationCount":"0","resultStr":"{\"title\":\"Real-world outcomes of neoadjuvant chemoimmunotherapy in patients with nonsmall cell lung cancer: Predictors of surgery, pathologic complete response, and event-free survival\",\"authors\":\"Alissa J. 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Clinical, demographic, and pathologic factors were incorporated in univariable and multivariable regression models to identify associations with outcomes (resection status, pathologic complete response [pCR], and subsequent event-free survival [EFS]) after standard-of-care neoadjuvant chemoIO.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Analyses included 115 patients, of whom 63% had stage III disease, 77% completed three cycles of chemoIO, and 78% underwent surgical resection. Ages older than 72 years versus 64 years and younger were associated with not proceeding to surgery in univariable (<i>p</i> = .006) and multivariable (<i>p</i> = .014) regression analyses. Nineteen patients (17%) had tumors with a pCR, and 34 (30%) had a major pathologic response. Positive programmed death-ligand 1 (PD-L1) expression (≥50%; vs. negative PD-L1 expression: odds ratio, 12.1; 95% confidence interval, 2.0–73.7; <i>p</i> = .007) and <i>KRAS</i> mutations (vs. wild-type <i>KRAS</i>: odds ratio, 3.9; 95% confidence interval, 1.07–14.4; <i>p</i> = .039) were associated with a higher probability of pCR in univariable analysis. The median event-free survival was not reached and did not differ among subgroups stratified by key clinical variables.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>The results from this study confirm the trial experience of high pCR rates after neoadjuvant chemoIO. 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Real-world outcomes of neoadjuvant chemoimmunotherapy in patients with nonsmall cell lung cancer: Predictors of surgery, pathologic complete response, and event-free survival
Background
Trials of neoadjuvant chemoimmunotherapy (chemoIO) have changed the standard of care for resectable nonsmall cell lung cancer (NSCLC). This study characterizes the outcomes of off-trial patients who received treatment with neoadjuvant chemoIO.
Methods
The authors analyzed records of patients with stage IB–III NSCLC who received neoadjuvant chemoIO with an intent to proceed to surgical resection at three US academic institutions. Clinical, demographic, and pathologic factors were incorporated in univariable and multivariable regression models to identify associations with outcomes (resection status, pathologic complete response [pCR], and subsequent event-free survival [EFS]) after standard-of-care neoadjuvant chemoIO.
Results
Analyses included 115 patients, of whom 63% had stage III disease, 77% completed three cycles of chemoIO, and 78% underwent surgical resection. Ages older than 72 years versus 64 years and younger were associated with not proceeding to surgery in univariable (p = .006) and multivariable (p = .014) regression analyses. Nineteen patients (17%) had tumors with a pCR, and 34 (30%) had a major pathologic response. Positive programmed death-ligand 1 (PD-L1) expression (≥50%; vs. negative PD-L1 expression: odds ratio, 12.1; 95% confidence interval, 2.0–73.7; p = .007) and KRAS mutations (vs. wild-type KRAS: odds ratio, 3.9; 95% confidence interval, 1.07–14.4; p = .039) were associated with a higher probability of pCR in univariable analysis. The median event-free survival was not reached and did not differ among subgroups stratified by key clinical variables.
Conclusions
The results from this study confirm the trial experience of high pCR rates after neoadjuvant chemoIO. This supports the use of chemoIO irrespective of KRAS mutation status, PD-L1 expression, and histology, but suggests that this approach may be less suitable for older patients.
期刊介绍：
The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society.
CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research
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