Abstract 161P
Background
Neoadjuvant (NA) chemotherapy (CT) and immunotherapy (IO) are the standard for resectable locally advanced NSCLC. Some patients show poor response to induction therapy, leading to worse outcomes compared to those with complete pathological responses, who benefit more in survival outcomes. The lack of predictive biomarkers highlights the need for their identification. This study characterizes and compares two cohorts treated with NACT-IO, showing extreme response differences (persistent disease vs complete pathological response), to identify factors associated with these outcomes.
Methods
Previously, we conducted a retrospective analysis of 163 patients with localized NSCLC treated with NA, including CT-IO. Two cohorts were analyzed: Cohort A, persistent disease (PD) pre- or post-surgery (≥50% tumor or ypN2), and Cohort B, complete pathological response (ypT0N0M0). Clinical variables, tissue/plasma alterations, and treatment aspects were evaluated. A descriptive and a univariate comparative analysis was performed to identify biomarkers of poor/complete response.
Results
Of 163 patients, 22 (14.1%) had persistent disease (PD), and 35 (21.1%) achieved a complete pathological response (CPR). Among them, 23 (14.1%) were evaluable due to available clinical data. We collected demographic, clinical, pathological, molecular, and therapy-related variables for the two cohorts. In this univariate comparative analysis, factors associated with poor vs complete response to neoadjuvant CT-IO included BMI >25 (p 0.05), comorbidities (p 0.013), no tobacco exposure (p 0.06), PD-L1 10 mg intake >7 days (p 0.019), carboplatin AUC (5 vs 6) (p < 0.001), and longer time to surgery (p < 0.001).
Conclusions
We identified factors potentially associated with poor vs complete response to NA CT-IO: BMI, comorbidities, tobacco exposure, PD-L1, driver alterations, anti-PD-1/PD-L1, prednisone >10 mg > 7 days, carboplatin AUC, and time to surgery. Larger studies are needed to confirm these findings.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.