WCLC 2025 - Posters & ePosters-EP.08.41 Tislelizumab Combined With Chemotherapy for Conversion Therapy in Stage III-N3 Non-Small Cell Lung Cancer: A Phase 2, Single-Arm Trial

EP.08.41 Tislelizumab Combined With Chemotherapy for Conversion Therapy in Stage III-N3 Non-Small Cell Lung Cancer: A Phase 2, Single-Arm Trial

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This phase 2, single-arm trial evaluated the efficacy and safety of combining tislelizumab, a PD-1 inhibitor, with chemotherapy as conversion therapy in technically resectable Stage III-N3 non-small cell lung cancer (NSCLC). The study enrolled six patients (three with adenocarcinoma and three with squamous cell carcinoma) who had no prior treatment, no sensitive EGFR mutations or ALK rearrangements, and good performance status (ECOG 0). Patients received 3-4 cycles of tislelizumab plus chemotherapy (nab-paclitaxel with cisplatin or carboplatin), followed by imaging reassessment and surgery within 4-8 weeks if resectable. Postoperative adjuvant tislelizumab was planned for up to one year.<br /><br />All six patients successfully underwent surgery (5 thoracoscopic lobectomies and 1 open pneumonectomy) with systematic lymph node dissection, achieving 100% R0 resection. Surgery averaged 328 minutes with minimal blood loss and no severe (Grade III-IV) complications; postoperative events included one air leak/pneumonia and one atrial fibrillation case. Pathologic assessment showed major tumor regression: 1 patient had pathological complete response (pCR), 4 patients had major pathological response (MPR), and 1 patient did not achieve MPR. Nodal downstaging was also observed.<br /><br />These preliminary results indicate that tislelizumab combined with chemotherapy can effectively shrink tumors and facilitate surgical resection in Stage III-N3 NSCLC, a subset typically challenging for surgery due to node involvement. This approach demonstrates promising efficacy and safety, suggesting a new direction for conversion therapy in locally advanced lung cancer. Ongoing data collection will further clarify long-term benefits such as event-free survival and overall survival. This strategy could expand curative options for a difficult patient population by integrating immunotherapy into multimodal treatment.

Asset Subtitle

Kai Ma

Meta Tag

Speaker Kai Ma

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

tislelizumab

PD-1 inhibitor

chemotherapy

conversion therapy

Stage III-N3 NSCLC

non-small cell lung cancer

surgical resection

major pathological response

pathological complete response

nodal downstaging