2024 World Conference on Lung Cancer (WCLC) - Posters-P2.07C.02 Prognostic Impact of Adjuvant Immunotherapy in Patients with Non-Small Cell Lung Cancer Following Neoadjuvant Immunotherapy

P2.07C.02 Prognostic Impact of Adjuvant Immunotherapy in Patients with Non-Small Cell Lung Cancer Following Neoadjuvant Immunotherapy

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The study explores the impact of adjuvant immunotherapy on patients with resectable non-small cell lung cancer (NSCLC) who have undergone neoadjuvant chemoimmunotherapy. Previous phase III trials demonstrate the effectiveness of neoadjuvant immunotherapy, with studies like IMpower-010 and PEARLS/KEYNOTE-091 highlighting its benefits. However, the KEYNOTE-091 trial found no improvement in disease-free survival for patients with PD-L1 expression levels of 50% or higher. This research suggests that PD-L1 expression influences the extent of benefits from postoperative adjuvant immunotherapy.<br /><br />The study included 438 patients with stage IB-IIIB NSCLC who received neoadjuvant treatment. The results show that patients who received adjuvant immunotherapy had significantly better recurrence-free survival (RFS) and overall survival (OS) than those who did not. Propensity-score matching was used to align the groups based on various factors, such as age, gender, smoking history, and PD-L1 expression, minimizing confounding variables.<br /><br />Subgroup analyses indicated that patients with a squamous histologic type and positive PD-L1 expression benefitted more from adjuvant immunotherapy. Postoperative treatment strategies were informed by pathological evaluations, showing significant benefits for patients with squamous histology who achieved major pathologic response (MPR). By contrast, those who did not achieve MPR might be resistant to immunotherapy, suggesting the need for alternative treatment regimens.<br /><br />The statistical analysis utilized the Kaplan-Meier method to estimate survival rates and the log-rank test for group comparisons. Cox proportional hazards models were fitted for subgroup analyses. Despite the demonstrated benefits of adjuvant immunotherapy in improving RFS and OS, the study calls for further investigation into optimal treatment strategies, particularly for patients who do not fully respond to immunotherapy.

Asset Subtitle

Yichen Dong

Meta Tag

Speaker Yichen Dong

Topic Early-Stage NSCLC

Keywords

adjuvant immunotherapy

non-small cell lung cancer

NSCLC

neoadjuvant chemoimmunotherapy

PD-L1 expression

recurrence-free survival

overall survival

squamous histology

major pathologic response

Kaplan-Meier method