2025 Targeted Therapies of Lung Cancer (TTLC) - Posters-PP01.49 Neoadjuvant PD-1 blockade in combination with chemotherapy for borderline resectable and unresectable stage III non-small cell lung cancer

PP01.49 Neoadjuvant PD-1 blockade in combination with chemotherapy for borderline resectable and unresectable stage III non-small cell lung cancer

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This study investigates the efficacy of neoadjuvant PD-1 blockade combined with chemotherapy in patients with borderline resectable and unresectable stage III non-small cell lung cancer (NSCLC) involving T4 and/or N2-N3 staging. Typically, patients at this advanced stage are treated with concurrent chemoradiotherapy followed by durvalumab consolidation, but this study explores a potentially more effective treatment strategy.<br /><br />In a multicenter retrospective analysis, pathological complete response (pCR), major pathological response (MPR), and event-free survival (EFS) were evaluated. Findings suggest high pathological response rates with increased resectability due to the combined treatment approach. This suggests that neoadjuvant PD-1 blockade with chemotherapy might be beneficial for patients who were previously considered surgically unresectable, warranting consideration in multidisciplinary treatment planning.<br /><br />The study had a participant pool with a median age of 66, involving both genders almost equally, and a range of smoking histories. Adenocarcinoma was the most common histological subtype observed. Regarding PD-L1 expression, the majority of patients showed varying degrees, with 41.7% having over 50% expression. Clinical stages varied, with IIIA being the most prevalent.<br /><br />Overall, the research supports the potential of this combined neoadjuvant treatment for improving surgical outcomes in advanced NSCLC, suggesting it should be evaluated on a case-by-case basis. The study's findings could influence future guidelines and therapeutic approaches for challenging NSCLC cases; however, the authors recommend further research to validate these findings and optimize patient selection criteria based on clinical and genomic predictors of response.

Asset Subtitle

Valentina Santo

Keywords

neoadjuvant PD-1 blockade

chemotherapy

non-small cell lung cancer

NSCLC

pathological complete response

major pathological response

event-free survival

resectability

PD-L1 expression

adenocarcinoma