Revolutionizing Localized Lung Cancer Treatment: Neoadjuvant Chemotherapy plus Immunotherapy for All?
Abstract
:1. Introduction
1.1. Overview and Epidemiology
1.2. Adjuvant and Neoadjuvant Chemotherapy
2. Neoadjuvant Immunotherapy plus Chemotherapy: The State of Art
2.1. Rational for the Use of Immunotherapy in the Neoadjuvant Setting in Resectable Lung Cancer
2.2. Combination of Chemo plus Immunotherapy before Surgery in Lung Cancer
2.3. Safety and PROs (QoL)
3. Challenges
3.1. Patients with Non pCR
3.2. Stage II
3.3. Oncogene-Driven NSCLC Population
4. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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CM816 | AEGEAN | KN671 | CM77T | |
---|---|---|---|---|
Total number of study patients | 358 | 802 | 797 | 461 |
Immunotherapy used | Nivolumab | Durvalumab | Pembrolizumab | Nivolumab |
Patients operated in the experimental arm (%) | 83.2% | 77.6% | 82.1% | 78% |
R0 (%) in the experimental arm | 83.2% | 92% | 94.7% | 89% |
pCR (%) in the experimental arm | 24% | 17.2% | 18.1% | 25.3% |
MPR (%) In the experimental arm | 36.9% | 33.3% | 30.2% | 35.4% |
Median of PFS (month) In the experimental arm | 31.6 | NR * | NR * | NR * |
Estimated OS In the experimental arm | NR * At 36 month | --- | 80.9% At 24 month | --- |
CM816 | AEGEAN | KN671 | CM77T | |||||
---|---|---|---|---|---|---|---|---|
Nivolumab | Chemo | Durva | Placebo | Pembro | Placebo | Nivolumab | Placebo | |
Safety & Surgery | ||||||||
Patients with definitive surgery | 149 (83.2) | 135 (75.4) | 324 (81.0) | 327 (81.3) | 326 (82.1) | 318 (79.5) | 178 (78) | 178 (77) |
Type of surgery:
| 115 (77.2) 25 (16.8) | 82 (60.7) 34 (25.2) | 238 (65.0) 27 (7.4) | 221 (59.1) 29 (7.8) | 256 (78.8) 37 (11.4) | 238 (75.1) 39 (12.3) | 142 (80) 16 (9) | 128 (72) 24 (14) |
Patients with cancelled surgery:
| 28 (15,6) 12 (6.7) 2 (1,1) | 37 (20,7) 17 (9.5) 1 (0.6) | 76 (19.0) 27 (6.8) 7 (1.8) | 75 (18.7) 30 (7.5) 5 (1.2) | 71 (17.9) 15 (3.8) 25 (6.3) | 82 (20.5) 26 (6.5) 17 (4.2) | 46 (20) 13 (6) 7 (3) | 50 (22) 22 (10) 4 (2) |
Adverses event identified as surgical complication | ||||||||
All | 41.6% | 46.7% | --- | --- | --- | --- | 73 (41) | 69 (39) |
Grade 3 and 4 | 11.4% | 14.8% | --- | --- | --- | --- | 21 (12) | 21 (12) |
Treatment related adverses event Grade 3 & 4 | ||||||||
All | 59 (33.5) | 65 (36.9) | 129 (32.4) | 131 (32.9) | (44.9) | (37.3) | 61 (27) | 52 (23) |
Leading to discontinuation of treatment | 10 (5.7) | 6 (3.4) | 26 (6.7) | 15 (3.8) | (12.6) | (5.3) | 18 (8) | 9 (4) |
Serious | 15 (8.5) | 14 (8.0) | 32,4% | 32,9% | (17.7) | (14.3) | --- | --- |
Death | 0 | 3 (1.7) | 7 (1.7) | 2 (0.5) | 1 (0.002) | 1 (0.002) | 2 (1) | 0 |
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Ferrari, V.; Helissey, C. Revolutionizing Localized Lung Cancer Treatment: Neoadjuvant Chemotherapy plus Immunotherapy for All? J. Clin. Med. 2024, 13, 2715. https://doi.org/10.3390/jcm13092715
Ferrari V, Helissey C. Revolutionizing Localized Lung Cancer Treatment: Neoadjuvant Chemotherapy plus Immunotherapy for All? Journal of Clinical Medicine. 2024; 13(9):2715. https://doi.org/10.3390/jcm13092715
Chicago/Turabian StyleFerrari, Victoria, and Carole Helissey. 2024. "Revolutionizing Localized Lung Cancer Treatment: Neoadjuvant Chemotherapy plus Immunotherapy for All?" Journal of Clinical Medicine 13, no. 9: 2715. https://doi.org/10.3390/jcm13092715