Abstract 961P
Background
Recent trials of IO prior to resection in locally advanced resectable NSCLC report high rates of pathological response and promising survival. However, primarily irresectable patients were excluded. Moreover, there is no data on CRT after IO in patients who are primarily not amenable to CRT. We hypothesized that induction IO may enable NSCLC patients with a potentially curative stage including oligometastatic disease (II – IVB [M1b]), for whom primary curative treatment (resection or CRT) is not possible for anatomical or functional reasons, to receive curative treatment.
Methods
We enrolled 59 NSCLC patients with aforementioned characteristics into a prospective real-world cohort of induction IO followed by morphologic and metabolic reassessment and multidisciplinary board-guided curative treatment (resection [preferred] or CRT) or palliative therapy. Primary endpoint was the proportion of patients receiving curative treatment, secondary endpoints included event-free survival (EFS) and overall survival (OS). Results of the first 35 patients have been published recently (KOMPASS-neo trial, Eur J Cancer (2021) 156:175). There was no funding.
Results
56 patients (95%) received curative treatment (23 R0 resections, 33 CRT). Of the completely resected patients, 11 had a major pathological response, including 9 with a pathological complete response. There were 23 recurrences: 3 (13%) in resected patients, 17 (52%) in CRT-patients, and 3 (100%) in palliative patients (FU 15 months). 21 deaths occurred (15 tumor-related deaths: 12 in CRT patients, and 3 in palliative patients; 2 treatment-related deaths (1 peri-operative, 1 RT pneumonitis); 4 other causes). 18-months OS and EFS were both 91% in the resection cohort compared to 66% and 49% in the RCT cohort.
Conclusions
In localized or oligometastatic NSCLC without a primary curative option, induction IO results in a high rate of curative treatment with promising early survival data. Resected patients achieved a high rate of prognostically favorable pathological response.
Clinical trial identification
NCT04926584.
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
S. Kramberg: Financial Interests, Personal, Invited Speaker: Roche. M. Faehling: Non-Financial Interests, Institutional, Principal Investigator: MSD, Roche, AstraZeneca; Financial Interests, Personal, Advisory Board: MSD, Roche, BMS; Financial Interests, Institutional, Advisory Board: AstraZeneca; Financial Interests, Personal, Invited Speaker: Sanofi. All other authors have declared no conflicts of interest.