2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.09B.04 Neoadjuvant Chemo-Immunotherapy Followed by Radical Surgery for Synchronous Oligometastatic Non-Small Cell Lung Cancer

EP.09B.04 Neoadjuvant Chemo-Immunotherapy Followed by Radical Surgery for Synchronous Oligometastatic Non-Small Cell Lung Cancer

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This study examines the outcomes of neoadjuvant chemo-immunotherapy followed by radical surgery in patients with synchronous oligometastatic non-small cell lung cancer (NSCLC), conducted at the IRCCS Regina Elena National Cancer Institute in Rome. Such patients lack a standardized therapeutic approach, and the study aims to evaluate the feasibility of a radical treatment strategy involving chemo-immunotherapy.<br /><br />A retrospective analysis was conducted on 11 patients treated between May 2020 and June 2023. These patients underwent platinum-based chemotherapy combined with immunotherapy, followed by radical surgery. The most common metastatic sites were the brain and contralateral lung. Metastasectomy, or surgical removal of metastases, was performed on ten patients. A pathological complete response (pCR)—indicating no detectable cancer post-treatment—was observed in six patients, accounting for 54.5% of the cohort.<br /><br />After a median follow-up of 16.5 months, all patients were alive and showed no cancer recurrence. Moreover, five patients received adjuvant immunotherapy following the surgery, with 45.5% of patients opting for the additional treatment.<br /><br />Demographics of the study group include a median age of 62, predominantly female (63.6%), with varying smoking histories and predominantly non-squamous histological features (90.9%). Patients had diverse tumor and node staging, with a significant portion having stage N2 involvement (54.5%). Regarding PD-L1 expression, a majority fell within the 1-49% range, potentially influencing their response to immunotherapy.<br /><br />The study concludes that this multimodal treatment approach is safe and feasible, yielding promising mid-term outcomes in selected patients with synchronous oligometastatic NSCLC. Such findings suggest that a radical treatment with curative intent may improve prognosis in this subset of patients.

Asset Subtitle

Filippo Tommaso Gallina

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Speaker Filippo Tommaso Gallina

Topic Metastatic Non-small Cell Lung Cancer – Local Therapies

Keywords

neoadjuvant chemo-immunotherapy

radical surgery

synchronous oligometastatic NSCLC

Regina Elena National Cancer Institute

platinum-based chemotherapy

pathological complete response

metastasectomy

adjuvant immunotherapy

PD-L1 expression

multimodal treatment