Neoadjuvant immunotherapy in resectable non-small-cell lung cancer.

Autor:	Chen LN; Division of Hematology & Oncology, Columbia University Irving Medical Center, New York, NY, USA., Wei AZ; Division of Hematology & Oncology, Columbia University Irving Medical Center, New York, NY, USA., Shu CA; Division of Hematology & Oncology, Columbia University Irving Medical Center, 161 Fort Washington Ave Fl 3, Herbert Irving Pavilion, New York, NY 10032, USA.
Jazyk:	angličtina
Zdroj:	Therapeutic advances in medical oncology [Ther Adv Med Oncol] 2023 Mar 28; Vol. 15, pp. 17588359231163798. Date of Electronic Publication: 2023 Mar 28 (Print Publication: 2023).
DOI:	10.1177/17588359231163798
Abstrakt:	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. Competing Interests: Dr. Shu reports personal fees from Arcus Biosciences, AstraZeneca, Genentech, Janssen, Mirati Therapeutics, Takeda outside the submitted work. Dr. Wei serves as a consultant and/or advisory board member for Castle Biosciences, Sanofi. (© The Author(s), 2023.)
Databáze:	MEDLINE
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