2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.07C.08 Surgical Factors and Adjuvant Therapy Use after Neoadjuvant Therapy for Patients with Resected Stage II-IIIB(N2) NSCLC

EP.07C.08 Surgical Factors and Adjuvant Therapy Use after Neoadjuvant Therapy for Patients with Resected Stage II-IIIB(N2) NSCLC

Back to course

Pdf Summary

This document discusses a study on surgical resection approaches and the application of neoadjuvant therapies, particularly immune checkpoint inhibitors (ICIs), for resectable non-small cell lung cancer (NSCLC). In recent years, the treatment paradigm for resectable, EGFR wild-type NSCLC has evolved to incorporate ICIs combined with platinum-based chemotherapy as neoadjuvant or perioperative regimens. Notably, the U.S. approvals of neoadjuvant nivolumab plus chemotherapy in 2022, and pembrolizumab in various combinations in 2023, have influenced treatment practices.<br /><br />The study employed a retrospective observational method using data from the Flatiron Health database, covering 2019 to 2023. The cohort included patients with stage II, IIIA, or IIIB(N2) NSCLC who had undergone tumor resection and received neoadjuvant therapy with or without ICIs. The study's findings revealed that as of 2022-2023, there was a substantial increase in the use of ICI-based neoadjuvant therapies compared to 2019-2021.<br /><br />A significant observation was the increasing preference for ICIs in patients with resectable NSCLC, particularly in those diagnosed in 2022-2023 (75% receiving ICI-based therapy versus 10% in earlier years). Additionally, the preference for a minimally invasive surgical approach remained unaffected by the type of neoadjuvant therapy. Analysis showed that lobectomy was the most common surgical method used, and robotic-assisted surgery was more frequent in patients receiving ICIs.<br /><br />The study concludes that evolving therapy strategies have not hindered minimally invasive surgical options and highlight the need for larger, longer-term studies to address therapy personalization and the trajectory of adjuvant therapy post-neoadjuvant chemoimmunotherapy. The findings stress the importance of continued research to adapt and optimize treatment strategies in line with advances in immunotherapy.

Asset Subtitle

Brendon Stiles

Meta Tag

Speaker Brendon Stiles

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

surgical resection

neoadjuvant therapies

immune checkpoint inhibitors

non-small cell lung cancer

EGFR wild-type

platinum-based chemotherapy

nivolumab

pembrolizumab

minimally invasive surgery

robotic-assisted surgery