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Войти в исследования Using Induction Chemoimmunotherapy as a Bridge to Definitive Local Therapy for Non-Metastatic NSCLC: Real-World Outcomes From a Comprehensive Cancer Center.
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Kleber Troy J, Copling Sage A, Kim Andrew D, Márquez César P, Dong Wenli, Rinsurongkawong Waree, Rinsurongkawong Vadeerat, Lee J Jack, Kitsel Yuliya, Han Xiaoyu, Ismail Sherif M, Xu Hui, Coronado Ivan, Liao Zhongxing, Chang Joe Y, Chen Aileen, Gandhi Saumil, Ning Matthew S, Nguyen Quynh-Nhu, O'Reilly Michael S, Qian David, Welsh James W, Chun Stephen G, Cascone Tina, Zhang Jianjun J, Gibbons Don L, Altan Mehmet, Vaporciyan Ara A, Rice David C, Rajaram Ravi, Mehran Reza J, Antonoff Mara B, Mitchell Kyle G, Weissferdt Annikka, Heymach John V, Wu Jia, Lin Steven H, Bronk Julianna K
Аннотация
PATIENTS AND METHODS: We analyzed patients with stage I-III NSCLC enrolled on a single-institution registry and treated with induction chemoimmunotherapy. Both surgical and non-surgical candidates, based on baseline evaluation, were included. For patients treated with definitive surgery or radiotherapy after induction chemoimmunotherapy, overall survival (OS) and progression free survival (PFS) were calculated from the time of surgery or the completion of radiotherapy, respectively.
RESULTS: Of the 168 patients identified, 72 (43%) were clinical stage III, 144 (86%) were surgical candidates at baseline, and 6 (4%) experienced disease progression during induction chemoimmunotherapy. Following induction chemoimmunotherapy, 115 (68% [or 80% of baseline surgical candidates]) underwent surgical resection, 44 (26%) received fractionated radiotherapy (FRT) as either conventional fractionation with chemotherapy (n = 30) or hypofractionation without chemotherapy (n = 14), 4 (2%) received stereotactic body radiotherapy, and 5 (3%) did not receive definitive local therapy. Maintenance immunotherapy was started for 29% of post-surgical patients and 61% of post-FRT patients, although its use was not associated with significant improvements in OS or PFS. OS and PFS also did not differ between FRT regimens.
CONCLUSION: Our findings demonstrate that induction chemoimmunotherapy is being adopted across a broad NSCLC population and can effectively bridge patients to various definitive therapy strategies. Variability in maintenance immunotherapy use and radiotherapy strategies highlights the need for prospective studies to define optimal treatment approaches.