WCLC Voice of China Professor Wu Nan's team: Neoadjuvant immune combination therapy emerges

The 2022 International Association for the Study of Lung Cancer (IASLC) World Conference on Lung Cancer (WCLC) will be held in offline + online format from August 6 to 9, 2022

Currently, several studies are exploring the efficacy of immunotherapy or targeted therapy in resectable non-small cell lung cancer (NSCLC)

background:

PD-1 inhibitors have good antitumor activity in NSCLC

method: 

The study included patients with stage IIB-IIIB EGFR/ALK wild-type NSCLC with an ECOG PS score of 0 or 1

Research design

result:

As of February 2022, a total of 53 eligible patients were enrolled in the study and received 2-4 cycles of neoadjuvant therapy, with a median age of 62 years, 9.

Twenty-five patients (25/39, 64.

Main results

Grade 1-2 treatment-related adverse events (TRAEs) occurred in 46 patients (46/49, 93.
9%)
.

Grade 3-4 TRAE occurred in 15 patients (15/49, 30.
6%)
.

Among the patients who underwent surgery, 3 patients (3/39, 7.
7%) had a grade 2-3 immunotherapy-related adverse event (irAE) (enteritis or rash) and received glucocorticoid therapy
.

Security Analysis

Notably, all 3 patients achieved pCR with a median interval between neoadjuvant therapy and surgery of 56 days (IQR: 56-70)
.

None of the 3 patients experienced treatment-related operative delays and additional operative difficulties compared with all patients who underwent surgery
.

This may suggest that patients with grade 2-3 irAEs had a higher pCR rate (100% vs 47.
2%)
.

Among patients who were not candidates for surgery, 2 developed grade 2-3 irAE (enteritis or pneumonitis) and received glucocorticoid therapy, and 1 patient achieved partial remission (PR) after neoadjuvant therapy and observed after 10 months To stable disease (SD), another patient achieved clinical complete remission (cCR) after neoadjuvant therapy
.

Among all 5 patients who developed irAEs and received glucocorticoids, the median time to onset of irAEs was 12 days (IQR: 7-54) and the median duration of glucocorticoid therapy was 12 days (IQR: 7-54) 79)
.

in conclusion:

Neoadjuvant toripalimab combined with platinum-based doublet therapy is a promising, tolerable, and effective treatment for patients with stage IIB-IIIB NSCLC
.

Notably, grade 2-3 irAEs were potentially associated with the efficacy of neoadjuvant toripalimab combination therapy
.

references:

EP05.
02-014 - Neoadjuvant Toripalimab Combination in Patients with Stage IIB-IIIB NSCLC: A Single-Arm, Phase 2 Trial (Renaissance Study).
WCLC 2022.

Edit: Xiaoyuan

Typography: Xiaoyuan

Execution: Traveller