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Poster session 04

1227P - Update on the analysis of operability parameter changes in neoadjuvant treatment with chemotherapy and anti-PD-1/PD-L1

Date

14 Sep 2024

Session

Poster session 04

Topics

Tumour Site

Non-Small Cell Lung Cancer

Presenters

Maria Sereno

Citation

Annals of Oncology (2024) 35 (suppl_2): S775-S793. 10.1016/annonc/annonc1600

Authors

M. Sereno1, A. Collazo-Lorduy2, J. Baena Espinar3, S. Falagán Martínez4, C. Aguado de la Rosa5, P. Cruz Castellanos6, L.E. Chara Velarde7, R. López-Castro8, A. López-Martin9, J. Rubio Perez10, A. Gomez Rueda11, C. Traseira Puchol12, X. Mielgo Rubio13, B. Losada Vila14, J. Rogado15, D. Gómez de Antonio16, E. Bernal Hertfelder17, L. Gutierrez Sainz18, G. Rubio Romero1, G. European University of Madrid UEM19

Author affiliations

  • 1 Oncology Department, Hospital Universitario Infanta Sofía, European University of Madrid, 28702 - Ss De Los Reyes/ES
  • 2 Medical Oncology Department, Hospital Universitario Puerta De Hierro, 28222 - Majadahonda/ES
  • 3 Medical Oncology Department, Hospital Universitario 12 Octubre, 28041 - Madrid/ES
  • 4 Medical Oncology Department, Hospital Universitario Infanta Sofía, 28703 - San Sebastian de los Reyes/ES
  • 5 Medical Oncology Department, Hospital Clinico Universitario San Carlos, 28040 - Madrid/ES
  • 6 Medical Oncology Department, Hospital Universitario de Cuidad Real, 13002 - Ciudad Real/ES
  • 7 Medical Oncology Department, Hospital Universitario de Guadalajara, 19002 - Guadalajara/ES
  • 8 Medical Oncology Department, Hospital Clinico Universitario de Valladolid, 47003 - Valladolid/ES
  • 9 Medical Oncology Department, Hospital Universitario Severo Ochoa, 28911 - Leganes/ES
  • 10 Medical Oncology Department, Hospital Universitario Fundacion Jiménez Díaz, 28040 - Madrid/ES
  • 11 Oncology Department, Hospital Universitario Ramon y Cajal, 28031 - Madrid/ES
  • 12 Medical Oncology Department, Hospital de Henares, 28222 - Coslada/ES
  • 13 Medical Oncology Department, Hospital Universitario Fundación Alcorcón, 28922 - Alcorcón/ES
  • 14 Medical Oncology Department, Hospital Universitario de Fuenlabrada, 28942 - Fuenlabrada/ES
  • 15 Medical Oncology Department, Hospital Universitario Infanta Leonor, 28031 - Madrid/ES
  • 16 Thoracic Surgery Department, Hospital Universitario Puerta De Hierro, 28222 - Majadahonda/ES
  • 17 Medical Oncology Department, Hospital Universitario Infanta Cristina, 28981 - Parla/ES
  • 18 Medical Oncology Dept., Hospital Universitario La Paz, 28046 - Madrid/ES
  • 19 Department Of Biostatistics, European University of Madrid UEM, 28670 - Madrid/ES

Resources

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Abstract 1227P

Background

The NA landscape for NSCLC has evolved with combined CT and IO, but data on functional effects are limited. This study examines and updates respiratory function impact with neoadjuvant NSCLC therapy.

Methods

From Jan 2020 to Apr 2024, we studied NSCLC patients receiving CT or CT with IO. We updated comparative analysis of respiratory function tests (DLCO, FEV1, FVC) between CT and CT-IO subgroups pre and post-NA treatment, with a larger case series. Clinical, pathological, surgical data were collected. Univariate regression was updated to identify variables influencing DLCO, FEV1, FVC changes.

Results

Studied 186 patients, median age 68, 66.6% men, 93% smokers/ex-smokers. Squamous and adenocarcinoma common (46% each), balanced PD-L1 expression. Non-G12C KRAS mutation prevalent (15%). Pre-NA stages analyzed: IIIA N2 52.6%, IIIA non-N2 18.8%, IIIB 8.6%. In this update, CT usage increased to 29%, CT-IO higher (70%). Surgery rate 85.7%, mainly lobectomy (83.3%). Downstaging 58.5%, ypTNM: cPR (37%), mPR (27%), ypN1/ypN2 (7% each). 31 pts didn’t undergo surgery: persistent N2 (35.4%), M1 (6%), complications (27%), functional inoperability (32%) Median pre-NA DLCO, FEV1, and FVC similar between CT and CT-IO. However, CT-IO led to greater DLCO decline than CT (12.6% vs. 7.8%, p 0.007). Also, significant increases in FEV1 (3.8% vs. -2.5%, p 0.001) and FVC (3.7% vs. -0.7%, p 0.003) noted. Complications during NA showed no significant differences, except for more immune-mediated adverse events in CT-IO (p 0.28). Ten patients weren’t eligible for surgery, with more functional deterioration in CT-IO (6/10), though not statistically significant (p 0.1). Conversions to thoracotomy more common in CT vs CT-IO (17% vs 10%, p 0.19), but CT-IO had more reinterventions within 90 days (4.2% vs 3.9%, p 1.0). Univariate regression showed significant relationship with DLCO decline, smoking (p 0.037), CT-IO treatment (P=0.03), and trend with COPD (p 0.058).

Conclusions

In this update on the impact of the type of NA on operability parameters, we found a significant difference between patients treated with CT-IO and CT subgroups, including lower DLCO and higher FEV1/FVC in the CT-IO group. Prospective validation is essential to confirm these findings.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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