WCLC 2025 - Posters & ePosters-EP.08.35 Accurate Pathologic Response Assessment of Lung Squamous Cell Carcinomatreated With Neoadjuvant Immunochemotherapytherapy

EP.08.35 Accurate Pathologic Response Assessment of Lung Squamous Cell Carcinomatreated With Neoadjuvant Immunochemotherapytherapy

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This study from Shanghai Pulmonary Hospital investigated the accuracy and consistency of two pathological response assessment methods—IASLC-recommended complete pathological response calculation (cPRC) and immune-related pathologic response criteria (irPRC)—in lung squamous cell carcinoma (LSCC) patients treated with neoadjuvant immunochemotherapy. A cohort of 83 LSCC patients undergoing surgery post-treatment between 2019 and 2023 was analyzed. Researchers digitized 778 H&E-stained surgical specimen sections and manually annotated tumor bed, residual viable tumor (RVT), and necrotic areas using Aperio ImageScope software.<br /><br />Pathological response was evaluated by calculating the percentage of RVT relative to tumor bed area through both cPRC (RVT% = viable tumor cell area/tumor bed area) and irPRC methods (a weighted calculation based on annotated areas). Results showed that 33.7% of patients achieved complete pathological response (CPR), another 33.7% had major pathological response (MPR), and 32.5% were considered non-MPR. Among non-CPR cases, discrepancies between the two methods in RVT% were minimal, with an average difference of 0.95% (range 0–7.9%). Most cases (74.5%) had differences under 2%, indicating high concordance. The kappa coefficient for agreement in pathological response classification between methods was 1, reflecting perfect consistency.<br /><br />The study concludes that both cPRC and irPRC are suitable for assessing pathological response in surgical specimens following neoadjuvant immunotherapy in LSCC. Notably, the irPRC offers slightly enhanced precision when RVT% is near critical thresholds like 10%, potentially improving evaluation accuracy in borderline cases. These findings support the clinical applicability of either method, with irPRC providing fine-tuned assessment for immunochemotherapy-treated lung cancer specimens.

Asset Subtitle

Shaoling Li

Meta Tag

Speaker Shaoling Li

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

Shanghai Pulmonary Hospital

lung squamous cell carcinoma

LSCC

neoadjuvant immunochemotherapy

complete pathological response calculation

cPRC

immune-related pathologic response criteria

irPRC

residual viable tumor

pathological response assessment