2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.08D.11 Redefining Prognosis in NSCLC after Neoadjuvant Immunotherapy: The Predictive Power of Pathologic Response and Lymph Node Status

EP.08D.11 Redefining Prognosis in NSCLC after Neoadjuvant Immunotherapy: The Predictive Power of Pathologic Response and Lymph Node Status

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This study by Yuan Xu and Hongsheng Liu examines the influence of pathologic response and lymph node status on progression-free survival (PFS) in patients with non-small cell lung cancer (NSCLC) who undergo neoadjuvant immunotherapy followed by surgical resection. In a retrospective analysis of 143 patients, with the majority being male (81.1%) and primarily diagnosed with squamous cell carcinoma (78.3%), the study investigates the correlation between these factors and clinical outcomes. <br /><br />The research findings indicate that both major pathological response (MPR) and complete pathological response (CPR) significantly improve PFS, showing statistical significance with a p-value of less than 0.01. However, there is no significant difference between MPR and CPR concerning PFS benefits (p-value of 0.15). Conversely, the involvement of lymph nodes negatively impacts PFS (p-value of less than 0.01). <br /><br />A new risk stratification model based on pathologic response and nodal status is effective in predicting prognosis, distinguishing between different 3-year PFS rates: 98.9%, 78.9%, and 53.3%. Gender, pathologic response, and lymph node stage were identified as independent predictors of PFS via Cox proportional hazards regression, with hazard ratios of 0.25 (p = 0.03), 6.02 (p = 0.01), and 2.30 (p = 0.01) respectively.<br /><br />In conclusion, the study suggests that MPR and CPR provide equal benefits in terms of PFS for NSCLC patients undergoing neoadjuvant immunotherapy. Lymph node status emerged as a critical factor in prognosis determination, even in cases initially deemed unresectable. The developed risk stratification aids in tailoring personalized treatment strategies for this patient population, enhancing management and outcomes.

Asset Subtitle

Yuan Xu

Meta Tag

Speaker Yuan Xu

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

non-small cell lung cancer

neoadjuvant immunotherapy

pathologic response

lymph node status

progression-free survival

major pathological response

complete pathological response

risk stratification model

Cox proportional hazards

personalized treatment