2024 World Conference on Lung Cancer (WCLC) - Posters-P3.08E.05 Radiological, Metabolic and Prognostic Features of Primary Tumor and Metastatic Lymph Node in Lung Cancer with Neoadjuvant Chemoimmunotherapy

P3.08E.05 Radiological, Metabolic and Prognostic Features of Primary Tumor and Metastatic Lymph Node in Lung Cancer with Neoadjuvant Chemoimmunotherapy

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The study titled "Radiological, Metabolic, and Prognostic Features of Primary Tumor and Metastatic Lymph Node in Lung Cancer with Neoadjuvant Chemoimmunotherapy" investigates the differences in response between primary tumors (PTs) and metastatic lymph nodes (mLNs) in non-small cell lung cancer (NSCLC) following neoadjuvant chemoimmunotherapy and subsequent surgery. The study enrolled 101 patients with locally advanced NSCLC and lymph node metastases to assess radiological, metabolic, and prognostic parameters.<br /><br />The results highlight the inefficacy of current tools in detecting residual tumors in mLNs after neoadjuvant treatment. It was found that the response to immunotherapy varies significantly between N1 and N2 lymph node stations, necessitating individualized evaluation. The study suggests that the pathological response of mLNs can provide additional prognostic information, although the impact is less significant than that of PTs. The findings propose a reconsideration of staging and adjuvant treatment strategies for patients with residual disease located only in mLNs, emphasizing the need for precise intraoperative detection tools and the preservation of tumor-free lymph nodes.<br /><br />Logistic regression and Kaplan-Meier survival analyses were performed to identify risk factors and assess patient prognosis. RNA sequencing was conducted on tissues from 16 patients to evaluate the tumor immune microenvironment. Distinct metabolic response patterns were noted in PTs and mLNs, and the study found that the maximum standardized uptake value (SUVmax) reduction rate and post-treatment SUVmax values were effective in distinguishing the pathological status of PTs, but not mLNs. This research underscores the complexity of treating NSCLC with lymph node involvement and points to the need for improved diagnostic and therapeutic approaches.

Asset Subtitle

Hao Li

Meta Tag

Speaker Hao Li

Topic Local-Regional NSCLC

Keywords

lung cancer

neoadjuvant chemoimmunotherapy

non-small cell lung cancer

metastatic lymph nodes

primary tumors

prognostic parameters

RNA sequencing

tumor immune microenvironment

standardized uptake value

diagnostic tools