Abstract 1225P
Background
Neoadjuvant and adjuvant immunotherapy provides benefit for patients with non-small cell lung cancer (NSCLC). However, there is a lack of studies specifically investigating the perioperative used of immunotherapy in squamous NSCLC.
Methods
This open-label, single-arm, phase II trial was conducted to evaluate the efficacy of perioperative serplulimab in patients with resectable squamous NSCLC. Eligible patients were aged from 18 to 75 and diagnosed with stage II-IIIA lung squamous cell carcinoma. Patients were given with intravenous serplulimab (300mg), in combination with (nab-) paclitaxel and carboplatin in 21-day cycles. Neoadjuvant therapy consisted of 2-3 cycles, while adjuvant therapy comprised 1-2 cycles, with a total of 4 cycles. The primary endpoint was major pathological response (MPR), defined as 10% or less viable tumor cells in the resected specimen.
Results
A total of 30 patients were enrolled. Among them, 16 (53.3%) patients had stage IIIA disease. Surgical resection was performed in 29 (97%) patients, with R0 resection achieved in 28 (93.3%) patients. MPR was observed in 23 (76.7%, 95%CI: 57.3-89.4%) patients, and pathological complete response (pCR) occurred in 15 (50%, 95%CI: 31.7-68.3%) patients. Neutropenia was the most prevalent grade 3-4 adverse events (13 [43%] of 30 patients). The clearance of circulating tumor DNA following neoadjuvant treatment was found to be a significant predictor of pCR (P=0.007), with a sensitivity of 78.6% and specificity of 76.9%.
Table: 1225P
Clinicopathologic characteristics of enrolled patients
Variables | Number (%) |
Age (years) | |
Mean ± SD | 63.7 ± 8.2 |
Median (IQR) | 65 (60-70) |
Sex | |
Female | 2 (6.7) |
Male | 28 (93.3) |
Smoking history | |
Never | 2 (6.7) |
Ever | 28 (93.3) |
ECOG | |
0 | 14 (46.7) |
1 | 16 (53.3) |
cTNM Stage | |
IIA | 2 (6.7) |
IIB | 12 (40) |
IIIA | 16 (53.3) |
Operative procedure∗ | |
Lobectomy | 17 (56.7) |
Sleeve resection | 6 (20) |
Bilobectomy | 5 (16.7) |
Pneumonectomy | 1 (3.3) |
Pathological response∗ | |
Pathological complete response | 15 (50) |
Major pathological response | 23 (76.7) |
Residual description∗ | |
R0 | 28 (93.3) |
R1/2 | 1 (3.3) |
∗ 29 patients underwent surgical resection.
Conclusions
Neoadjuvant and adjuvant serplulimab plus platin-based chemotherapy could be a promising treatment for resectable squamous NSCLC, yielding high MPR and pCR rates, with manageable adverse events (Funded by Shanghai Henlius Biotech and Burning Rock Biotech, NCT05775796).
Clinical trial identification
Protocol Number: HLX10IIT21, ECTOP-1013; NCT05775796.
Editorial acknowledgement
Legal entity responsible for the study
Haiquan Chen.
Funding
Shanghai Henlius Biotech and Burning Rock Biotech.
Disclosure
All authors have declared no conflicts of interest.
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