2024 Asia Conference on Lung Cancer (ACLC) - Poster & ePosters-PP02.27

PP02.27 - Yuechun Lin

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The study investigated the clinical outcomes and recurrence patterns in patients with non-small cell lung cancer (NSCLC) who achieved a pathological complete response (pCR) after receiving neoadjuvant therapy followed by surgery. Conducted across eight institutions, it included patients diagnosed with stage IIA to IIIC NSCLC from January 2018 to December 2023. Among the patients who achieved pCR, 19 experienced recurrence: 12 cases of local recurrence and 10 cases of distant recurrence, with three resulting in death due to disease progression.<br /><br />Patients who received neoadjuvant immunotherapy showed a high rate of locoregional recurrence (78.6%) and a moderate rate of distant recurrence (42.9%). Those who underwent at least three cycles of neoadjuvant therapy saw a 90.9% incidence of local recurrence and a 36.4% incidence of distant recurrence. The median time to locoregional recurrence was longer than to distant recurrence (12.0 months vs. 9.5 months). All patients underwent lobectomy with R0 resection, and the study found no variations in the extent of mediastinal lymph node dissection among patients with different recurrence types.<br /><br />The findings underscore that even patients achieving pCR may still be at risk of relapse, necessitating stricter monitoring. However, patients receiving at least three cycles of neoadjuvant immunotherapy demonstrated a significantly reduced rate of distant recurrence. This suggests that extended neoadjuvant immunotherapy might lower postoperative recurrence risks. The study emphasizes the need for vigilant post-surgery surveillance and possibly expanded neoadjuvant therapy protocols to enhance patient outcomes in NSCLC cases.

Keywords

non-small cell lung cancer

pathological complete response

neoadjuvant therapy

surgery

recurrence patterns

immunotherapy

locoregional recurrence

distant recurrence

postoperative surveillance

mediastinal lymph node dissection