WCLC 2025 - Posters & ePosters-P2.08 .37 Neoadjuvant Chemoimmunotherapy in Resectable NSCLC. Real-World Evidence From a Spanish Multicenter Cohort

P2.08 .37 Neoadjuvant Chemoimmunotherapy in Resectable NSCLC. Real-World Evidence From a Spanish Multicenter Cohort

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This Spanish multicenter retrospective study assessed neoadjuvant chemoimmunotherapy (N-CT-IO) in 106 patients with resectable non-small cell lung cancer (NSCLC) stages IB-IIIC across 10 institutions. Patients, predominantly stage IIIA (58.5%) with adenocarcinoma (54.7%) or squamous histology (42.5%), had a median age of 64.3 years and were mostly male (64%) with good performance status (ECOG 0-1, 98%). KRAS mutations were present in 54.2% of tested cases. The most common neoadjuvant regimen was carboplatin, paclitaxel, and nivolumab (64.2%). Surgical resection was achieved in 88.7% of patients.<br /><br />The study focused on pathological complete response (pCR), event-free survival (EFS), and overall survival (OS), exploring outcomes by PD-L1 expression, KRAS mutation status, and Lung Immune Prognostic Index (LIPI) score. The overall pCR rate was 41.5%. No significant differences in pCR were seen across PD-L1 subgroups, but higher pCR rates were noted among patients with favorable or intermediate LIPI scores. KRAS mutation status did not significantly affect pCR rates.<br /><br />Overall survival analysis revealed that patients with high PD-L1 expression (≥50%) had superior outcomes, with a median OS of 43.2 months and no deaths during follow-up, whereas those with PD-L1 <1% experienced worse survival (median OS 28.2 months). Intermediate survival was observed in patients with PD-L1 1–49%.<br /><br />The study confirms the feasibility and efficacy of neoadjuvant chemoimmunotherapy in real-world clinical settings, with pathologic responses and survival outcomes aligning with those reported in pivotal clinical trials such as CheckMate 816 and NADIM. These findings support N-CT-IO as a standard of care in resectable NSCLC, highlighting its benefit irrespective of molecular alterations and reinforcing the prognostic value of PD-L1 expression and LIPI scores in treatment outcomes.

Asset Subtitle

Karla Medina Sanchez

Meta Tag

Speaker Karla Medina Sanchez

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

neoadjuvant chemoimmunotherapy

non-small cell lung cancer

NSCLC stages IB-IIIC

pathological complete response

PD-L1 expression

KRAS mutation

Lung Immune Prognostic Index

overall survival

event-free survival

carboplatin paclitaxel nivolumab