Real World Radiographic Response Rates and Preoperative Attrition in Patients With Non–Small Cell Lung Cancer (NSCLC) Treated With Neoadjuvant Chemoimmunotherapy

作者：Cole Friedes, Michelle Iocolano, Nikhil Yegya‐Raman, John C. Kucharczuk, Taine Pechet, Roger B. Cohen, Charu Aggarwal, Melina E. Marmarelis, William P. Levin, Keith A. Cengel, Christine Ciunci, Christopher D’Avella, Aditi Singh, Christiana Davis, Corey J. Langer, J.D. Bradley, Steven J. Feigenberg · 发表于：American Journal of Clinical Oncology · 年份：2025 · DOI：10.1097/coc.0000000000001260 · 被引用次数：2 · 研究领域：Lung Cancer Diagnosis and Treatment、Radiomics and Machine Learning in Medical Imaging、Lung Cancer Research Studies

OBJECTIVES: To evaluate real-world rates of radiographic response and surgery in patients treated with neoadjuvant chemoimmunotherapy for stage II to III NSCLC. METHODS: We evaluated a prospectively maintained single-institution database of patients of stage II to III NSCLC treated with neoadjuvant chemoimmunotherapy from January 2022 to July 2024. Rates of radiographic response, surgery, and reasons for abandoning surgery were recorded. Toxicity was graded according to the Common Terminology Criteria for Adverse Events for systemic treatment and the Clavien-Dindo Scale for surgery. RESULTS: Overall, 1243 patients were screened: 323 had stage II-III NSCLC that could be treated with curative intent, of whom 111 were considered eligible for surgery and 36 were treated with neoadjuvant chemoimmunotherapy, which will reflect the remainder of this report. The overall response rate (ORR) was 53% and median radiographic change in the sum of tumor diameter was -34% (IQR -44 to -11). In patients with PD-L1 ≥50%, the ORR was 76%. Most patients had evidence of radiographic downstaging after neoadjuvant treatment. The rate of surgical intervention was 58% (n=21). No patient thought to require a pneumonectomy before neoadjuvant therapy underwent surgery. Pathologic complete response rate was seen in 5 of the 21 patients (24%). There were 42 adverse events from chemoimmunotherapy and 19 from surgery, of which 12% and 11% were grade 3 or higher, respectively. CONCLUSIONS: At a tertiary care...