Neoadjuvant Chemoimmunotherapy for Resectable Stage IIIA NSCLC
Posted: Thursday, February 11, 2021
According to the phase II NADIM study results published in The Lancet Oncology, the survival of patients with locally advanced lung cancer may be improved with chemotherapy plus immunotherapy administered before surgery. In addition, the neoadjuvant therapy appeared to be well tolerated and not associated with delays in surgery.
In this multicenter, nonrandomized trial conducted in Spain, Mariano Provencio, MD, of the University Hospital Puerta de Hierro, and colleagues evaluated the safety and efficacy of a combination of three cycles of chemotherapy (nivolumab) before surgery, followed by 1 year of treatment with immunotherapy, in 46 patients with stage IIIA non–small cell lung cancer.
Almost 90% of participants survived after 2 years, and 77% were progression-free during this period. During neoadjuvant treatment, 43 of 46 patients had treatment-related adverse events, of which 14 were grade 3 or worse, including increased lipase and febrile neutropenia. None of the adverse events were found to be associated with surgery delays or deaths.
“The incorporation of immunotherapy in earlier stages, when the disease can still be cured, and combination with chemotherapy have been the most two key factors behind these good results,” stated coauthor Ernest Nadal, MD, of the Catalan Institute of Oncology, in a press release.
A follow-up randomized phase II trial is underway to determine the superiority of the combination of chemotherapy with immunotherapy compared with preoperative chemotherapy alone. Currently, 70 patients are enrolled, and results are expected throughout 2021.
“Neoadjuvant chemoimmunotherapy could change the perception of locally advanced lung cancer as a potentially lethal disease to one that is curable,” the authors commented.
Disclosure: Full authors’ disclosures are available at thelancet.com.