Oncoimmunology · 2026
Reshaping immunotherapy sequencing strategy: equivalent survival with induction plus consolidation vs. consolidation-only strategy in unresectable stage III NSCLC.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Chen Wenlu, Zhao Anqi, Liang Yu, Cao Xin, Wu Baixue, Zhou Yuying, Zhang Wenbo, Zhao Meng, Hou Qing, Yao Ningning, Li Feng, Duan Jianchun, Zhang Shuangping, Bi Nan, Cao Jianzhong
Аннотация
OBJECTIVE: To compare the efficacy and safety of a sequential combination of chemoradiotherapy (CRT) with immune checkpoint inhibitors (ICIs) administered as induction plus consolidation versus consolidation-only in patients with unresectable stage III non-small cell lung cancer (NSCLC).
METHODS: This retrospective study enrolled 265 patients treated at two centers between March 2019 and August 2023. Patients were categorized into a consolidation-only group (n = 153) and an induction plus consolidation group (n = 112). Propensity score matching (PSM, 1:1 ratio) was used to balance baseline characteristics. Progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan-Meier analysis and log-rank tests. Adverse events (AEs) were evaluated according to CTCAE v5.0.
RESULTS: Before PSM, no significant survival differences were observed between groups (2-y PFS: 52.6% vs. 63.5%, p = 0.085; 2-y OS: 91.7% vs. 81.2%, p = 0.822). After PSM, outcomes remained comparable (2-y PFS: 56.8% vs. 62.2%, p = 0.179; 2-y OS: 94.9% vs. 87.9%, p = 0.514). Before PSM, the most common AE was pneumonitis (60.7% vs. 55.1%, p = 0.442). The induction plus consolidation group showed a lower incidence of anemia (p = 0.004) but a higher incidence of ALT/AST elevation (14.3% vs. 5.1%, p = 0.022). The incidence of all other AEs was comparable (p > 0.05). After PSM, only anemia was significantly higher in the consolidation-only group (52.8% vs. 27.8%, p = 0.004).
CONCLUSION: In treatment-tolerant patients, induction plus consolidation therapy demonstrated comparable efficacy and safety to consolidation-only therapy in unresectable stage III NSCLC.
METHODS: This retrospective study enrolled 265 patients treated at two centers between March 2019 and August 2023. Patients were categorized into a consolidation-only group (n = 153) and an induction plus consolidation group (n = 112). Propensity score matching (PSM, 1:1 ratio) was used to balance baseline characteristics. Progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan-Meier analysis and log-rank tests. Adverse events (AEs) were evaluated according to CTCAE v5.0.
RESULTS: Before PSM, no significant survival differences were observed between groups (2-y PFS: 52.6% vs. 63.5%, p = 0.085; 2-y OS: 91.7% vs. 81.2%, p = 0.822). After PSM, outcomes remained comparable (2-y PFS: 56.8% vs. 62.2%, p = 0.179; 2-y OS: 94.9% vs. 87.9%, p = 0.514). Before PSM, the most common AE was pneumonitis (60.7% vs. 55.1%, p = 0.442). The induction plus consolidation group showed a lower incidence of anemia (p = 0.004) but a higher incidence of ALT/AST elevation (14.3% vs. 5.1%, p = 0.022). The incidence of all other AEs was comparable (p > 0.05). After PSM, only anemia was significantly higher in the consolidation-only group (52.8% vs. 27.8%, p = 0.004).
CONCLUSION: In treatment-tolerant patients, induction plus consolidation therapy demonstrated comparable efficacy and safety to consolidation-only therapy in unresectable stage III NSCLC.