Huang Xuhua, Zhu Linhai, Liu Jiacong, Wang Yanye, Wang Yiqing, Xia Pinghui, Lv Wang, Hu Jian
Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, China.
Key Laboratory of Clinical Evaluation Technology for Medical Device of Zhejiang Province, Hangzhou, 310003, China.
Discov Oncol. 2024 Aug 31;15(1):390. doi: 10.1007/s12672-024-01278-5.
This retrospective study evaluated the individual benefits of tislelizumab and surgery, as well as their synergistic effect on progression-free survival (PFS) and overall survival (OS) of stage II-III non-small cell lung cancer (NSCLC) patients.
From September 2019 to June 2022, all participants with potentially resectable NSCLC who received chemotherapy (C) or tislelizumab plus chemotherapy (T) were included in the study. Participants were categorized into four groups based on surgery or not (S or NS) and the utilization of tislelizumab (T or C). Progression-free survival (PFS) and overall survival (OS) were evaluated using the Kaplan-Meier method and log-rank test, as well as Cox proportional hazards models.
Compared to C, T was associated with significantly higher objective response rate (64.54% vs. 34.78%, p = 0.003), higher pathological complete response rate (40.00% vs. 14.06%, p = 0.007), and higher major pathological response rate (60.00% vs. 20.31%, p < 0.001). The T + S group exhibited a proportionately higher reduction in the risk of disease progression or death compared to the sum of the T + NS group and C + S group. Regardless of C or T, surgery was associated with improved OS (p < 0.01). Without surgery, T did not show significant improvement in PFS or OS. However, with surgery, T significantly improved both PFS and OS (ps < 0.01).
Tislelizumab with subsequent surgery synergistically improves the survival benefits in patients with NSCLC.
本回顾性研究评估了替雷利珠单抗和手术的个体获益，以及它们对II - III期非小细胞肺癌（NSCLC）患者无进展生存期（PFS）和总生存期（OS）的协同作用。
2019年9月至2022年6月，所有接受化疗（C）或替雷利珠单抗联合化疗（T）的具有潜在可切除NSCLC的参与者被纳入研究。参与者根据是否接受手术（S或NS）以及替雷利珠单抗的使用情况（T或C）分为四组。采用Kaplan - Meier法、对数秩检验以及Cox比例风险模型评估无进展生存期（PFS）和总生存期（OS）。
与C组相比，T组的客观缓解率显著更高（64.54%对34.78%，p = 0.003），病理完全缓解率更高（40.00%对14.06%，p = 0.007），主要病理缓解率更高（60.00%对20.31%，p < 0.001）。与T + NS组和C + S组的总和相比，T + S组在疾病进展或死亡风险方面呈现出更高比例的降低。无论C组还是T组，手术均与OS改善相关（p < 0.01）。未接受手术时，T组在PFS或OS方面未显示出显著改善。然而，接受手术时，T组显著改善了PFS和OS（p < 0.01）。
替雷利珠单抗联合后续手术可协同改善NSCLC患者的生存获益。
