Abstract 1160P
Background
Treatment combination of immune checkpoint inhibitor (ICI) and platinum-based chemotherapy brought benefits for stage IIIA-IIIB non-small cell lung cancer (NSCLC) patients. This study evaluated the therapeutic feasibility of PD-1 plus platinum-doublet chemotherapy for potentially resectable NSCLC.
Methods
We retrospectively collected demographic and treatment data of potentially resectable NSCLC patients treated with neoadjuvant chemo-immunotherapy (toripalimab/pembrolizumab, etc.) between Mar 2019 and Jan 2021. Inclusion criteria: stage IIIA-IIIB, non-driver gene mutation, complete medical record and ECOG 0-1.
Results
A total of 56 patients (median age: 58, IQR: 46-74; female: 2, 3.6%) were enrolled, including 47 (83.9%) with squamous cell carcinoma and 15 (26.8%) with stage IIIB disease. Six patients refused surgery and 5 did not qualify. A total of 45 (80.4%) patients underwent surgery, all with R0. Before surgery, patients received a median of 2 doses. The interval between neoadjuvant therapy last dose and surgery was 35 days. Among the 45 evaluated patients, 31 (68.9%) achieved major pathological response (MPR), 18 (40.0%) had pathological complete response (pCR), while 37 (82.2%) had pathological downstaging and none had surgical complications. The median follow-up was 11 (IQR: 2-27) months. On April 18, 2021, 3 patients relapsed. All Grade (G) treatment-related AEs (TRAEs) occurred in 33 patients (33/56). G ≥ 3 TRAEs were found in 3 patients (1 immune enteritis; 1 alanine aminotransferase increase; 1 pneumonia). Two patients delayed surgery following increased G3 alanine aminotransferase and G2 myocarditis. MPR or pCR patients had significantly lower baseline expression of SPRR3 (p = 3.93*10ˆ-7), KRT4 (p = 4.83*10ˆ-15), KRT13 (p = 4.82*10ˆ-09), ADAMTS20 (p = 6.92*10ˆ-10) and SERPINA3 (p = 2.68*10ˆ-10). For irAE patients, ERBB2 (p = 0.038), MDK (p = 0.015) and MUC16 (p = 0.0018) expression baselines were significantly lower while those of complement component 2 paralog (p = 3.21*10ˆ-15) and PIWIL1 (p = 0.026) were higher than non-irAE patients.
Conclusions
ICI and platinum-doublet chemotherapy for potentially resectable NSCLC is effective and tolerable.
Clinical trial identification
NCT04324151.
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
L. Guo: Other, Personal, Full or part-time Employment: Shanghai Junshi Biosciences Co. Y. Guan: Other, Personal, Full or part-time Employment: Geneplus-Beijing Institute. X. Gao: Other, Personal, Full or part-time Employment: Geneplus-Beijing Institute. H. Wang: Other, Personal, Full or part-time Employment: Geneplus-Beijing Institute. X. Xia: Other, Personal, Full or part-time Employment: Geneplus-Beijing Institute. All other authors have declared no conflicts of interest.