2022 World Conference on Lung Cancer (ePosters)-EP02.04-008. Efficacy and Safety of Neoadjuvant Chemoimmunotherapy in Resectable Non-small Cell Lung Cancer (NSCLC): a systematic review and meta-analysis

EP02.04-008. Efficacy and Safety of Neoadjuvant Chemoimmunotherapy in Resectable Non-small Cell Lung Cancer (NSCLC): a systematic review and meta-analysis

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This systematic review and meta-analysis aimed to evaluate the efficacy and safety of neoadjuvant chemoimmunotherapy in resectable non-small cell lung cancer (NSCLC) patients. The study included 9 phase II clinical trials and 1 phase III trial, comprising a total of 471 patients. <br /><br />The meta-analysis of 447 patients from 9 trials showed an overall pooled major pathological response (MPR) rate of 49.2%, with high heterogeneity. The pooled estimate for pathological complete response (pCR) from 10 trials including 471 patients was 27.5%. <br /><br />The analysis found a significant association between MPR and PD-L1 expression, with PD-L1-positive patients having higher odds of achieving MPR. However, this effect diminished when age, tumor histology, and PD-L1 status were considered together. None of these factors were correlated with achieving a pCR. <br /><br />Three trials with 137 patients reported a 24-month overall survival (OS) rate of 84.4% with low heterogeneity, indicating positive long-term outcomes. <br /><br />The most common grade 3/4 adverse events from neoadjuvant treatment were neutropenia, diarrhea, fatigue, and anemia. The most common any-grade adverse events were fatigue, alopecia, diarrhea, anemia, and neutropenia.<br /><br />Combining chemotherapy and immune checkpoint inhibitors (ICIs) in neoadjuvant settings appears to be an effective and feasible option for resectable NSCLC patients. The study highlights the importance of PD-L1 expression in predicting response to treatment. Further investigation is needed to understand the effects of tumor size and tumor mutational burden (TMB) on MPR and pCR for better treatment selection.

Asset Subtitle

Sebawe Syaj

Meta Tag

Speaker Sebawe Syaj

Topic Early Stage Non-small Cell Lung Cancer - Systemic Therapy

Keywords

neoadjuvant chemoimmunotherapy

resectable non-small cell lung cancer

NSCLC patients

pooled major pathological response

pathological complete response

PD-L1 expression

overall survival rate

adverse events

chemotherapy

immune checkpoint inhibitors