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Is Neoadjuvant PD-1 Inhibition Plus Chemotherapy of Benefit in Locally Advanced NSCLC?

By: Julia Fiederlein
Posted: Monday, January 10, 2022

Previous studies have suggested that patients with resectable non–small cell lung cancer (NSCLC) may benefit from neoadjuvant therapy plus a PD-1 inhibitor. On this basis, Xinsheng Zhu, MD, of the Tongji University School of Medicine, Shanghai, and colleagues conducted an open-label, single-arm, phase II clinical trial of neoadjuvant toripalimab plus chemotherapy in a population with locally advanced NSCLC. Based on the interim results, which were presented during the European Society for Medical Oncology (ESMO) Congress 2021 (Abstract 1176P) and published in the Annals of Oncology, this combination appeared to be safe and effective.

A total of 48 patients with stage IIA to IIIC wild-type EGFR/ALK NSCLC received two to four courses of toripalimab plus carboplatin-based chemotherapy. After the second treatment cycle, they were reassessed by the multidisciplinary team. Patients who were eligible for complete resection underwent surgery; those who were ineligible received the remaining treatment cycles.

Of the 40 patients who received radiologic reassessment during the last neoadjuvant treatment cycle, 2 had progressive disease, 8 had stable disease, 23 had a partial response, and 7 had a complete response. All patients who underwent surgery (n = 22) had a complete resection without any serious surgical complications, the investigators reported; a total of 40.9% and 18.2% of this population achieved a major pathologic response and pathologic complete response, respectively.

No treatment-related deaths were reported; treatment-related adverse events were observed in 87.5% of patients. According to the investigators, 6.2% of patients experienced serious treatment-related adverse events involving myelosuppression, pulmonary infection, and drug-induced liver injury.

Disclosure: The study authors reported no conflicts of interest.



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