2023 World Conference on Lung Cancer (Posters)-P1.27. Neoadjuvant PD-1 Blockade Plus Platinum-based Chemotherapy for EGFR-mutant NSCLC (CTONG2104): An Interim Analysis

P1.27. Neoadjuvant PD-1 Blockade Plus Platinum-based Chemotherapy for EGFR-mutant NSCLC (CTONG2104): An Interim Analysis - PDF(Slides)

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A phase 2 trial (NEOTIDE/CTONG2104) investigated the efficacy of neoadjuvant sintilimab plus chemotherapy in early-stage EGFR-mutant non-small cell lung cancer (NSCLC). Neoadjuvant immunochemotherapy has shown promise in treating early-stage NSCLC, but its effectiveness in EGFR-mutant NSCLC is unclear.<br /><br />The study included 18 patients who received three cycles of intravenous sintilimab, nab-paclitaxel, and carboplatin. Among the 18 patients who completed neoadjuvant treatment and underwent surgery, 78% achieved a partial response and 22% had stable disease. For patients who underwent surgery, 44% achieved a major pathological response, with 4 patients showing near pathological complete response.<br /><br />Patients with sensitive EGFR mutations, exon20 insertion, and other uncommon EGFR mutations achieved 30%, 75%, and 50% major pathological response, respectively. Adverse events were observed in all patients, with 39% experiencing grade 3/4 treatment-related adverse events. One patient had a severe adverse event of hemoptysis.<br /><br />Blood and tissue samples collected from 12 patients were analyzed using a tumor-informed personalized ctDNA panel. All 12 patients had detectable ctDNA, and 81% had corresponding EGFR mutations. Pre-surgery ctDNA detection showed relatively high positive predictive value and negative predictive value.<br /><br />The study concluded that neoadjuvant sintilimab plus chemotherapy is feasible and has a tolerable safety profile in EGFR-mutant NSCLC, including patients with uncommon subtypes. These findings complement the use of neoadjuvant immunochemotherapy as standard-of-care treatment for localized NSCLC. The study plans to evaluate long-term survival outcomes, the role of tumor-informed minimal residual disease detection during the perioperative period, and the value of pretreatment immune phenotype in selecting patients for immunotherapy in EGFR-mutant NSCLC.

Asset Subtitle

Chao Zhang

Meta Tag

Speaker Chao Zhang

Topic Early-Stage NSCLC: Innovation & New Technology

Keywords

NEOTIDE/CTONG2104

neoadjuvant sintilimab

chemotherapy

EGFR-mutant non-small cell lung cancer

NSCLC

neoadjuvant immunochemotherapy

partial response

stable disease

major pathological response

ctDNA panel