2024 World Conference on Lung Cancer (WCLC) - Posters-P1.08C.04 Delineating the Prognosis Spectrum: Disentangling Primary Tumor and Lymph Node Responses in NSCLC Following Neoadjuvant Immunotherapy

P1.08C.04 Delineating the Prognosis Spectrum: Disentangling Primary Tumor and Lymph Node Responses in NSCLC Following Neoadjuvant Immunotherapy

Back to course

Pdf Summary

This study investigates the prognostic implications of primary tumor (PT) and lymph node (LN) responses to neoadjuvant immunotherapy in non-small cell lung cancer (NSCLC) using a semi-quantitative analysis. It aims to clarify how responses in these two areas affect patient prognosis independently, given the importance of achieving pathological Complete Response (pCR) and Major Pathological Response (MPR).<br /><br />The research included 315 patients, all treated under a standardized protocol combining immunotherapy and chemotherapy. The study boasts a high R0 resection rate of 97.1%. Despite this, a clear discordance was observed between PT and LN responses. The median Disease-Free Survival (DFS) in participants was 32.6 months, while the median Overall Survival (OS) was not reached. Importantly, no tumor progression was noted in patients with complete LN regression, regardless of PT residual rates.<br /><br />Patients were clustered into four groups: those with complete and incomplete LN regression, each with PT residuals of over 50%. Survival analysis revealed stark contrasts: the median DFS for the PT50%NpCR group was 40.0 months, whereas the PT50%nNpCR group showed a significantly lower DFS of 9.8 months.<br /><br />The study emphasizes the critical role LN response plays in determining prognosis post-neoadjuvant immunotherapy for NSCLC. The data indicate that complete LN regression significantly enhances survival outcomes, regardless of the PT's residual status. These findings suggest a need for further studies to confirm these observations on a larger scale and explore potential therapeutic interventions focusing on LN response to improve personalized cancer treatment strategies.

Asset Subtitle

Long Jiang

Meta Tag

Speaker Long Jiang

Topic Local-Regional NSCLC

Keywords

prognostic implications

primary tumor response

lymph node response

neoadjuvant immunotherapy

non-small cell lung cancer

pathological complete response

major pathological response

disease-free survival

overall survival

complete LN regression