Zhou Shijie, Hao Xuefeng, Yu Daping, Liu Shuku, Cao Xiaoqing, Su Chongyu, Song Xiaoyun, Xiao Ning, Li Yunsong, Yang Wei, Zhao Dan, Wang Jinghui, Liu Zhidong, Xu Shaofa
Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Department of Pathology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Zhongguo Fei Ai Za Zhi. 2021 Jun 20;24(6):420-425. doi: 10.3779/j.issn.1009-3419.2021.102.13. Epub 2021 May 24.
Preliminary researches conformed that neoadjuvant immunotherapy combined with chemotherapy had a significant short-term effect in resectable non-small cell lung cancer (NSCLC), but there were few clinical trials about neoadjuvant chemoimmunotherapy in China. We aimed to assess retrospectively the antitumour activity and safety of neoadjuvant chemoimmunotherapy for resectable stage Ib-IIIb NSCLC.
Twenty patients who had been diagnosed as stage Ib-IIIb NSCLC and received chemoimmunotherapy as neoadjuvant treatment between November 2019 and December 2020, in Beijing Chest Hospital, Capital Medical University were recruited. These patients received neoadjuvant treatment for 21 days as a cycle and antitumour activity and safety were evaluated every two cycles.
Of 20 patients received neoadjuvant chemoimmunotherapy, 17 patients underwent surgical resection. 16 patients had R0 resection (no residual tumor resection) and 1 patient had R1 resection (microscopic residual tumor resection). Radiographic objective response rate (ORR) was 85.0% (4 complete response, 13 partial response). 5.0% (1/20) of patients had stable disease, and 10.0% (2/20) of patients had progression disease. The major pathologic response (MPR) was 47.1% (8/17), and complete pathologic response (CPR) was 29.4% (5/17). 1 case developed grade IV immune-related pneumonia (IRP) and 9 (45.0%) cases had grade III hematologic toxicity.
Immunotherapy combined with chemotherapy as neoadjuvant therapy has a better efficiency and tolerable adverse effects for patients with resectable NSCLC in stage Ib-IIIb.
初步研究证实,新辅助免疫治疗联合化疗对可切除的非小细胞肺癌(NSCLC)具有显著的短期疗效,但中国关于新辅助化疗免疫治疗的临床试验较少。我们旨在回顾性评估新辅助化疗免疫治疗对可切除的Ib-IIIb期NSCLC的抗肿瘤活性和安全性。
招募了20例于2019年11月至2020年12月间在北京胸科医院(首都医科大学)被诊断为Ib-IIIb期NSCLC并接受化疗免疫治疗作为新辅助治疗的患者。这些患者接受21天的新辅助治疗为一个周期,每两个周期评估抗肿瘤活性和安全性。
在接受新辅助化疗免疫治疗的20例患者中,17例接受了手术切除。16例患者实现R0切除(无残留肿瘤切除),1例患者实现R1切除(显微镜下有残留肿瘤切除)。影像学客观缓解率(ORR)为85.0%(4例完全缓解,13例部分缓解)。5.0%(1/20)的患者病情稳定,10.0%(2/20)的患者病情进展。主要病理缓解(MPR)为47.1%(8/17),完全病理缓解(CPR)为29.4%(5/17)。1例发生IV级免疫相关肺炎(IRP),9例(45.0%)发生III级血液学毒性。
免疫治疗联合化疗作为新辅助治疗对Ib-IIIb期可切除NSCLC患者具有较好的疗效和可耐受的不良反应。