2023 World Conference on Lung Cancer (Posters)-P2.07. Development of Postoperative Bronchopleural Fistula after Neoadjuvant Immunochemotherapy in Non-small Cell Lung Cancer: Case Reports

P2.07. Development of Postoperative Bronchopleural Fistula after Neoadjuvant Immunochemotherapy in Non-small Cell Lung Cancer: Case Reports - PDF(Abstract)

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This study focuses on the development of bronchopleural fistula (BPF) after neoadjuvant immunochemotherapy in patients with non-small cell lung cancer (NSCLC). The advent of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of advanced NSCLC, and their inclusion in neoadjuvant treatment regimens has become necessary. However, immune-related adverse events (irAEs) limit the application of ICIs to a certain extent. BPF is a rare but serious complication after pneumonectomy, especially in patients who receive neoadjuvant immunotherapy or chemoimmunotherapy.<br /><br />The study reports on 4 patients who developed postoperative BPF after receiving neoadjuvant sintilimab and chemotherapy. The patients were mostly male, smokers, and had central type lung cancer with stage III. Detailed descriptions of the surgical procedures were available for 7 patients, with 3 undergoing pneumonectomy and 4 undergoing lobectomy. The study also summarizes the pathological changes observed after the surgery. 50% of the resected tumors showed a major pathological response, with reparative changes mainly in the tumor bed and significant fibrous tissue proliferation. In the other 2 patients, the tumor bed showed immune infiltrative changes accompanied by necrosis and lymphocyte infiltration.<br /><br />The study emphasizes that although BPF is rare in patients receiving neoadjuvant immunochemotherapy, it should be given more attention due to its life-threatening nature. It suggests that reinforcement of the bronchial stump should be recommended in cases of neoadjuvant immunochemotherapy for lung cancer patients, especially those at higher risk of BPF, such as those with central type lung cancer of stage III. The findings of this study contribute to a better understanding of neoadjuvant immunochemotherapy in the management of NSCLC.

Asset Subtitle

Kewei Ma

Meta Tag

Speaker Kewei Ma

Topic Metastatic NSCLC: Immunotherapy - Retrospective

Keywords

bronchopleural fistula

neoadjuvant immunochemotherapy

non-small cell lung cancer

immune checkpoint inhibitors

immune-related adverse events

pneumonectomy

sintilimab

chemotherapy

pathological changes

central type lung cancer