Abstract 338P
Background
To date, there remains a paucity of comparative investigations about preoperative immunochemotherapy and conventional chemotherapy in the context of limited-stage small-cell lung cancer (LS-SCLC) patients. This study conducted a comprehensive comparative assessment concerning the safety and efficacy profiles of preoperative immunochemotherapy and chemotherapy in individuals diagnosed with stage I–IIIB SCLC.
Methods
This investigation collected 53 consecutive patients diagnosed with LS-SCLC spanning stage I to IIIB who underwent preoperative immunochemotherapy or conventional chemotherapy at our hospital from January 2019 to July 2021. Patients were allocated to receive 2–4 cycles of neoadjuvant immunochemotherapy or chemotherapy, with each cycle lasting three weeks. Comprehensive analyses encompassed baseline characteristics, clinical staging, tumor response, intraoperative and postoperative outcomes, and the assessment of treatment-related adverse events (trAEs). The follow-up period is extended for a minimum of one year after surgery.
Results
The objective response rate of the immunochemotherapy group was higher (89.5%) than that of the chemotherapy group(75.0%, P=0.206). The surgical resection rate of the immunochemotherapy group was 48.3% (14/29), which was higher than the chemotherapy group (20.8%, 5/24). After neoadjuvant treatment, there were more patients in stage 0 in the immunochemotherapy group andwe could find significant difference between these two groups (P=0.009). The rates of major pathological response (MPR) and pathological complete remission (pCR) in the immunochemotherapy group were 57.1% and 7.1%, respectively, which were both higher than the chemotherapy group (MPR: 40.0%, pCR: 0.0%), but there was no significant difference (P=0.073). The median DFS for both groups were not reached. The mean DFS was 39.8 months for the immunochemotherapy group versus 28.8 months for the chemotherapy group (P=0.43). There was no significant difference in the incidence of grade 3–4 toxicities between the immunochemotherapy group and the chemotherapy group.
Conclusions
For patients with stage I–IIIB SCLC, neoadjuvant immunochemotherapy as first-line therapy is feasible and safe.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.