WCLC 2025 - Posters & ePosters-EP.07.51 Long-Term Egfr-Tki as Neoadjuvant Therapy Effectively Achieved Depth of Pathological Response

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This retrospective study from Xiangya Hospital evaluated the efficacy and safety of long-term third-generation EGFR-TKI as neoadjuvant therapy in 13 patients with stage IA-IVA EGFR-mutant non-small cell lung cancer (NSCLC) treated between 2022 and 2024. Patients received regular doses of EGFR-TKI for at least three months prior to surgery, with eight patients undergoing treatment for over six months. The primary endpoint was pathological depth of response (pDepOR), reflecting tumor shrinkage on pathology after therapy.<br /><br />Results showed that 84.6% of patients achieved varied degrees of pDepOR: 30.8% had ≥95% tumor response, 53.8% had 50-95%, and 15.4% had 26-50%. Objective response rate (ORR) was 46.2% and disease control rate (DCR) was 100%. Importantly, no grade 3 adverse events occurred preoperatively. Surgical outcomes were favorable, with most operations completed within 2 hours, minimal blood loss (≤50ml in 84.6%), postoperative drainage of 200-400ml, and drainage tubes removed within 4 days. Patients were all discharged within 5 days, indicating that prolonged EGFR-TKI neoadjuvant treatment did not complicate surgery.<br /><br />This study addresses limitations of shorter neoadjuvant EGFR-TKI duration reported in prior trials (e.g., NEOS trial showing minimal pathological response with 6-week therapy) by demonstrating that extended administration enhances pathological tumor response without increasing surgical difficulty or complications. The authors conclude that long-term third-generation EGFR-TKI as neoadjuvant therapy effectively deepens tumor response and supports safer surgical resection in EGFR-mutant NSCLC. Continued enrollment aims to validate these promising findings.<br /><br />In summary, extended neoadjuvant EGFR-TKI treatment offers a potent and well-tolerated approach for tumor downstaging in resectable EGFR-mutant NSCLC, potentially improving long-term outcomes by increasing pathological response depth without compromising perioperative safety.

Asset Subtitle

Yuan Da Cheng

Meta Tag

Speaker Yuan Da Cheng

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

EGFR-TKI

third-generation EGFR-TKI

neoadjuvant therapy

non-small cell lung cancer

NSCLC

pathological depth of response

tumor shrinkage

objective response rate

disease control rate

surgical outcomes