Neoadjuvant chemoimmunotherapy shows high pathological response in squamous lung cancer
Neoadjuvant chemoimmunotherapy showed a 51.5% pathological complete response rate in 127 patients with resectable squamous cell lung cancer. Grade 3-4 treatment-related adverse events occurred in 11.8% of patients.
Neoadjuvant chemoimmunotherapy demonstrated high pathological response rates with “manageable” toxicity in patients with resectable squamous cell lung cancer, according to data presented at the European Lung Cancer Congress. A retrospective, multicenter cohort study across 16 medical centers in Italy, Spain and the U.K. included 127 patients who previously received at least one cycle of neoadjuvant chemoimmunotherapy. Researchers plan to continue following the cohort to confirm long-term efficacy outcomes.
Following the CheckMate 816 trial that led to the approval of neoadjuvant chemoimmunotherapy for resectable non-small cell lung cancer, the study evaluated pathological response and the incidence and severity of immune-related adverse events as primary endpoints. Secondary endpoints included clinical, demographic and pathological features, treatment-associated adverse events, and 1-year event-free survival and overall survival.
The study included 127 patients, 69.3% men and 97.6% current or former smokers. Researchers observed a 51.5% pathological complete response rate. The 1-year event-free survival rate was 75.6% (95% CI, 68.1-84) for the overall cohort and 96% (95% CI, 91-100) among patients who achieved pathological complete response.
Overall, 13 patients experienced local relapse, nine patients had an intrathoracic relapse and 13 experienced metastatic relapse. Grade 3 to grade 4 treatment-related adverse events occurred in 11.8% of patients and grade 3 immune-related adverse events in 7.1%. Ten patients discontinued treatment; seven were due to treatment toxicity.
Most patients received the carboplatin plus paclitaxel combination, whereas CheckMate 816 used cisplatin plus gemcitabine. Continued monitoring of long-term immune-related adverse events is needed, and researchers said they aim to study the tumor microenvironment of nonresponders to understand why some patients do not benefit from this regimen and how emerging therapies might help modulate that microenvironment.