The Lung Cancer Channel is supported with funding from Johnson & Johnson (Gold) and Takeda (Gold).
VJOncology is an independent medical education platform. Supporters, including channel supporters, have no influence over the production of content. The levels of sponsorship listed are reflective of the amount of funding given to support the channel.
WCLC 2025 | Neoadjuvant chemo-IO in borderline resectable stage III NSCLC
Biagio Ricciuti, MD, Dana-Farber Cancer Institute, Boston, MA, discusses results from a multicenter cohort study evaluating neoadjuvant PD-(L)1 blockade plus platinum-based chemotherapy in patients with borderline resectable or unresectable stage III non-small cell lung cancer (NSCLC). Encouraging surgical outcomes were reported in T4 and/or N2-N3 stage III NSCLC. Patients achieving pCR had significantly improved event-free survival, while co-mutations in KRAS/STK11 or KRAS/KEAP1 were linked to poor response. This interview took place at 2025 World Conference on Lung Cancer (WCLC) in Barcelona, Spain.
These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.
Transcript
So today for patients with stage 3, a non-small cell lung cancer that’s considered non-resectable, standard of care is still concurrent chemo-radiation therapy followed by consolidation immunotherapy. However with neoadjuvant chemo-immunotherapy approaches, these therapies today they can offer potentially a different approach for patients that are borderline resectable but possibly also for a small fraction of highly selected patients that are considered today non-resectable...
So today for patients with stage 3, a non-small cell lung cancer that’s considered non-resectable, standard of care is still concurrent chemo-radiation therapy followed by consolidation immunotherapy. However with neoadjuvant chemo-immunotherapy approaches, these therapies today they can offer potentially a different approach for patients that are borderline resectable but possibly also for a small fraction of highly selected patients that are considered today non-resectable. And so in this study we really set out to address the question, can we use neoadjuvant chemoimmunotherapy in real world for patients who have unresectable or borderline resectable stage 3 non-small cell lung cancer. In this study we did identify 112 patients who had stage 3 borderline or non-resectable non-small cell lung cancer. This means they had a T4 tumor without N2 or N3 nodal involvement. Of these patients, 17.5% ultimately were able to undergo surgical resection. So all these patients were treated with neoadjuvant chemoimmunotherapy and approximately 75% did receive a surgical resection, which was successful. Of these patients, of course, our interest was looking into the complete pathologic response rate, the major pathological response, and ultimately also the event-free survival. And it was interesting to learn that the complete pathological response rate was 29%, not too different compared to the pCR rate we have seen in stage 2 to 3b resectable non-small cell lung cancer in landmark clinical trials. The pCR rate was 42% and the event-free survival was approximately 52 months. Certainly pretty impressive event-free survival. This is a retrospective study, of course, with many biases, but still it does challenge the current standard of care for a fraction of these patients with borderline or non-resectable lung cancer and future trials, some of which have actually been presented at this meeting, are currently converging towards the idea that this should be an approach we could consider for a small fraction of these patients.
This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.
Read more...
