Neoadjuvant immunotherapy for advanced, resectable non–small cell lung cancer: A systematic review and meta‐analysis

Cancer, Journal Year: 2023, Volume and Issue: 129(13), P. 1969 - 1985

Published: March 30, 2023

Abstract Background Neoadjuvant immunotherapy (nIT) is a rapidly emerging paradigm for advanced resectable non‐small cell lung cancer (NSCLC). The objectives of this PRISMA/MOOSE/PICOD‐guided systematic review and meta‐analysis were (1) to assess the safety efficacy nIT, (2) compare neoadjuvant chemoimmunotherapy (nCIT) versus chemotherapy alone (nCT), (3) explore predictors pathologic response with nIT their association outcomes. Methods Eligibility was stage I–III NSCLC receipt programmed death‐1/programmed death ligand‐1 (PD‐L1)/cytotoxic T‐lymphocyte–associated antigen‐4 inhibitors before resection; other forms modalities and/or adjuvant therapies allowed. For statistical analysis, Mantel–Haenszel fixed‐effect or random‐effect model used, depending on heterogeneity (I 2 ). Results Sixty‐six articles met criteria (eight randomized studies, 39 prospective nonrandomized 19 retrospective studies). pooled complete (pCR) rate 28.1%. estimated grade ≥3 toxicity 18.0%. Compared nCT, nCIT achieved higher rates pCR (odds ratio [OR], 7.63; 95% confidence interval [CI], 4.49–12.97; p < .001), progression‐free survival (PFS) (hazard [HR] 0.51; CI, 0.38–0.67; overall (OS) (HR, 0.36–0.74; = .0003) but yielded similar (OR, 1.01; 0.67–1.52; .97). results remained robust sensitivity analysis when all publications removed. associated improved PFS 0.25; 0.15–0.43; .001) OS 0.26; 0.10–0.67; .005). PD‐L1 expressors (≥1%) more likely achieve 2.93; 1.22–7.03; .02). Conclusions In patients NSCLC, safe efficacious. PFS/OS over particularly in who had tumors that expressed PD‐L1, without increasing toxicities. Plain Language Summary This 66 studies showed alone, survival, ligand‐1,

Language: Английский

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Current and Future Treatment Options in the Management of Stage III NSCLC

Journal of Thoracic Oncology, Journal Year: 2023, Volume and Issue: 18(11), P. 1478 - 1491

Published: Aug. 11, 2023

Language: Английский

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Neoadjuvant durvalumab plus radiation versus durvalumab alone in stages I–III non-small cell lung cancer: survival outcomes and molecular correlates of a randomized phase II trial

Nature Communications, Journal Year: 2023, Volume and Issue: 14(1)

Published: Dec. 19, 2023

Abstract We previously reported the results of a randomized phase II trial (NCT02904954) in patients with early-stage non-small cell lung cancer (NSCLC) who were treated either two preoperative cycles anti-PD-L1 antibody durvalumab alone or combined immunomodulatory doses stereotactic radiation (DRT). The met its primary endpoint major pathological response, which was significantly higher following DRT no new safety signals. Here, we report on prespecified secondary disease-free survival (DFS) regardless treatment assignment and exploratory analysis DFS each arm trial. at 2 3 years across both arms 73% (95% CI: 62.1–84.5) 65% 52.5–76.9) respectively. For trial, three-year 63% 46.0–80.4) monotherapy compared to 67% 49.6–83.4) dual therapy arm. In addition, post hoc progression-free as well molecular correlates response recurrence through high-plex immunophenotyping sequentially collected peripheral blood gene expression profiles from resected tumors arms. Together, our contribute evolving landscape neoadjuvant regimens for NSCLC identify easily measurable potential biomarkers recurrence.

Language: Английский

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Immunotherapy in Early-Stage Non-Small Cell Lung Cancer (NSCLC): Current Evidence and Perspectives

Current Oncology, Journal Year: 2023, Volume and Issue: 30(4), P. 3684 - 3696

Published: March 27, 2023

Lung cancer is the leading cause of deaths in world. Surgery most potentially curative therapeutic option for patients with early-stage non-small cell lung (NSCLC). The five-year survival these remains poor and variable, depending on stage disease at diagnosis, risk recurrence following tumor resection high. During last 20 years, there has been a modest improvement strategies resectable NSCLC. Immune checkpoint inhibitors (ICIs), alone or combination chemotherapy, have become cornerstone treatment metastatic NSCLC patients. Recently, their clinical development shifted neoadjuvant adjuvant settings where they demonstrated remarkable efficacy, to improved outcomes. Based positive results from phase III trials, ICIs settings. On October 2021 Food Drug Administration (FDA) approved atezolizumab as an surgery platinum-based chemotherapy whose tumors express PD-L1 ≥ 1%. In March 2022, nivolumab platinum-doublet was adult setting. current review provides updated overview trials exploring role immunotherapy NSCLC, focusing biological rationale use perioperative We will also discuss potential predictive biomarkers personalize therapy optimize incorporation into multimodality management I-III

Language: Английский

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Immune checkpoint inhibitors promising role in cancer therapy: clinical evidence and immune-related adverse events

Medical Oncology, Journal Year: 2023, Volume and Issue: 40(8)

Published: July 15, 2023

Language: Английский

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