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Neoadjuvant immunotherapy in resectable non-small-cell lung cancer

The advent of immune checkpoint inhibition has pushed the treatment paradigm for resectable non-small-cell lung cancer (NSCLC) toward neoadjuvant therapy. A growing number of promising trials have examined the utility of neoadjuvant immunotherapy, both alone and in combination with other modalities...

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Autores principales: Chen, Lanyi Nora, Wei, Alexander Z., Shu, Catherine A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052589/
https://www.ncbi.nlm.nih.gov/pubmed/37007633
http://dx.doi.org/10.1177/17588359231163798
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author Chen, Lanyi Nora
Wei, Alexander Z.
Shu, Catherine A.
author_facet Chen, Lanyi Nora
Wei, Alexander Z.
Shu, Catherine A.
author_sort Chen, Lanyi Nora
collection PubMed
description The advent of immune checkpoint inhibition has pushed the treatment paradigm for resectable non-small-cell lung cancer (NSCLC) toward neoadjuvant therapy. A growing number of promising trials have examined the utility of neoadjuvant immunotherapy, both alone and in combination with other modalities such as radiation therapy (RT) and chemotherapy. The phase II LCMC3 and NEOSTAR trials demonstrated a role for neoadjuvant immunotherapy in inducing meaningful pathologic responses, and another phase II trial established the feasibility of combining neoadjuvant durvalumab with RT. Significant interest in neoadjuvant chemoimmunotherapy resulted in the conduct of multiple successful phase II trials including the Columbia trial, NADIM, SAKK 16/14, and NADIM II. Across these trials, neoadjuvant chemoimmunotherapy led to high rates of pathologic response and improved surgical outcomes without compromising surgical timing or feasibility. CheckMate-816, which was a randomized phase III trial studying neoadjuvant nivolumab in addition to chemotherapy, definitively established a benefit for neoadjuvant chemoimmunotherapy compared to chemotherapy alone for resectable NSCLC. Despite the growing literature and success of these trials, several outstanding questions remain, including the relationship between pathologic response and patient survival, the role of biomarkers such as programmed death ligand 1 and circulating tumor DNA in determining patient selection and treatment course, and the utility of additional adjuvant therapies. Longer follow-up of CheckMate-816 and other ongoing phase III trials may help address these questions. Ultimately, the complexity of managing resectable NSCLC highlights the importance of a multidisciplinary approach to patient care.
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spelling pubmed-100525892023-03-30 Neoadjuvant immunotherapy in resectable non-small-cell lung cancer Chen, Lanyi Nora Wei, Alexander Z. Shu, Catherine A. Ther Adv Med Oncol Review The advent of immune checkpoint inhibition has pushed the treatment paradigm for resectable non-small-cell lung cancer (NSCLC) toward neoadjuvant therapy. A growing number of promising trials have examined the utility of neoadjuvant immunotherapy, both alone and in combination with other modalities such as radiation therapy (RT) and chemotherapy. The phase II LCMC3 and NEOSTAR trials demonstrated a role for neoadjuvant immunotherapy in inducing meaningful pathologic responses, and another phase II trial established the feasibility of combining neoadjuvant durvalumab with RT. Significant interest in neoadjuvant chemoimmunotherapy resulted in the conduct of multiple successful phase II trials including the Columbia trial, NADIM, SAKK 16/14, and NADIM II. Across these trials, neoadjuvant chemoimmunotherapy led to high rates of pathologic response and improved surgical outcomes without compromising surgical timing or feasibility. CheckMate-816, which was a randomized phase III trial studying neoadjuvant nivolumab in addition to chemotherapy, definitively established a benefit for neoadjuvant chemoimmunotherapy compared to chemotherapy alone for resectable NSCLC. Despite the growing literature and success of these trials, several outstanding questions remain, including the relationship between pathologic response and patient survival, the role of biomarkers such as programmed death ligand 1 and circulating tumor DNA in determining patient selection and treatment course, and the utility of additional adjuvant therapies. Longer follow-up of CheckMate-816 and other ongoing phase III trials may help address these questions. Ultimately, the complexity of managing resectable NSCLC highlights the importance of a multidisciplinary approach to patient care. SAGE Publications 2023-03-28 /pmc/articles/PMC10052589/ /pubmed/37007633 http://dx.doi.org/10.1177/17588359231163798 Text en © The Author(s), 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Chen, Lanyi Nora
Wei, Alexander Z.
Shu, Catherine A.
Neoadjuvant immunotherapy in resectable non-small-cell lung cancer
title Neoadjuvant immunotherapy in resectable non-small-cell lung cancer
title_full Neoadjuvant immunotherapy in resectable non-small-cell lung cancer
title_fullStr Neoadjuvant immunotherapy in resectable non-small-cell lung cancer
title_full_unstemmed Neoadjuvant immunotherapy in resectable non-small-cell lung cancer
title_short Neoadjuvant immunotherapy in resectable non-small-cell lung cancer
title_sort neoadjuvant immunotherapy in resectable non-small-cell lung cancer
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052589/
https://www.ncbi.nlm.nih.gov/pubmed/37007633
http://dx.doi.org/10.1177/17588359231163798
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