Abstract 218P
Background
For decades, definitive chemoradiation and surgery with adjuvant chemotherapy in selected cases constituted the standard approaches for stage 3 NSCLC; however, promising outcomes of adjuvant immunotherapy trials established the framework for pre/perioperative chemo-immunotherapy studies. Pre/perioperative chemoimmunotherapy has emerged as a favored treatment modality due to its potential for downstaging and enhancement of the pathological objective response. The fact that objective response appears as a surrogate endpoint for survival suggests that other treatments that augment neoadjuvant therapy may also be effective in this patient group.
Methods
In this study, patients who were followed up in a tertiary oncology center between January 2010 and January 2025 due to stage 3 NSCLC and received induction triplet chemotherapy regimen (gemcitabine-cisplatin-paclitaxel) were retrospectively examined.
Results
A total of 97 patients received induction triplet regimen. Median age of the group was 61 and vas majority of patients were male (92.7%). A total of 59 patients SCC, followed by adenocarcinoma (32 pts). Approximately half of the patients (47.4%) were stage 3A followed by stage 3B, 3C and 2B, respectively (40.2%, 7.2%, and 5.2%). Most patients completed (86%) pre-planned treatment regimen while 10 patients stopped treatment due to grad 3–4 toxicity. An objective radiological response was achieved 85 of 97 patients (76 PR, 9 CR). After induction triplet regimen 30 patients (31%) underwent surgery while 52 patients (53.6) received definitive chemoradiation. Among 6 of 30 resected patients (20%) a ypCR was achieved. While 24 patients were in remission at the last follow-up, disease recurrence was observed in 59 patients and 6 patients were lost to follow-up. Median RFS was 18.6 months. A total of 51 patients died during follow-up. Median overall survival (OS) of the group was 42 months.
Conclusions
Induction regimen with triplet chemotherapy appears to be an effective neoadjuvant treatment option according to this retrospective patient group. A pathological complete response rate of 20% indicates a high efficacy similar to the results of recent immunotherapy studies. This option can be an alternative for patients fit patients with borderline resectable disease.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.