Abstract 197P
Background
In the era of advancing immunotherapy, the optimal combination of immune checkpoint inhibitors (ICIs) and chemoradiotherapy (CRT) for stage III non-small cell lung cancer (NSCLC) remains unclear. This study focuses on patients with unresectable stage III NSCLC to evaluate the efficacy and safety of induction chemoimmunotherapy combined with definitive CRT (dCRT).
Methods
We retrospectively collected data from 361 patients with unresectable NSCLC treated at three hospitals between 2018 and 2023. Outcomes assessed included objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety.
Results
A total of 361 patients were included: 112 in the induction chemo-immunotherapy group, 151 in the consolidation immunotherapy group, and 98 in the combination group (induction chemo-immunotherapy + consolidation immunotherapy). The ORR were 47 (50.0%), 85 (60.3%), and 38 (48.1%), respectively. Corresponding DCR were 66 (70.2%), 125 (88.7%), and 51 (64.6%). The median follow-up time was 17.4 months. Median PFS was 21.1 months (95% CI: 16.5–NA) in the induction chemo-immunotherapy group, 40.6 months (95% CI: 39.4–NA) in the consolidation immunotherapy group, and 29.2 months (95% CI: 17.1–NA) in the combination group. Median OS was not reached in the induction chemo-immunotherapy group, while it was 52.5 months in the consolidation immunotherapy group and 42.4 months in the combination group. Local recurrences were observed in 15 (13.6%), 23 (15.3%), and 16 (16.4%) patients, while distant metastases occurred in 17 (15.5%), 28 (18.9%), and 18 (18.4%) patients in the respective groups. Adverse events (AEs) included radiation pneumonitis in 46 (58.7%), 61 (45.2%), and 51 (52.0%) patients; radiation esophagitis in 37 (33.3%), 82 (54.3%), and 34 (34.7%) patients; and immune-related pneumonitis in 37 (33.0%), 82 (54.3%), and 34 (34.7%) patients, respectively.
Conclusions
Induction chemo-immunotherapy combined with CRT demonstrated manageable toxicity in patients with unresectable stage III NSCLC. However, significant survival benefits were not observed.
Legal entity responsible for the study
Shanxi province Cancer Hospital.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.