Induction immunochemotherapy followed by definitive chemoradiotherapy for unresectable locally advanced non‐small cell lung cancer: a multi‐institutional retrospective cohort study
Abstract This study aimed to evaluate the efficacy and safety of induction immunochemotherapy followed by definitive chemoradiotherapy (CRT) for unresectable locally advanced non‐small cell lung cancer (LA‐NSCLC). We identified unresectable stage III NSCLC patients who received induction immunochemo...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-03-01
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| Series: | MedComm |
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| Online Access: | https://doi.org/10.1002/mco2.501 |
| _version_ | 1797231379513081856 |
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| author | Leilei Wu Bo Cheng Xiaojiang Sun Zhenshan Zhang Jingjing Kang Yun Chen Qinghua Xu Shuangyan Yang Yujie Yan Shengxiang Ren Caicun Zhou Yaping Xu |
| author_facet | Leilei Wu Bo Cheng Xiaojiang Sun Zhenshan Zhang Jingjing Kang Yun Chen Qinghua Xu Shuangyan Yang Yujie Yan Shengxiang Ren Caicun Zhou Yaping Xu |
| author_sort | Leilei Wu |
| collection | DOAJ |
| description | Abstract This study aimed to evaluate the efficacy and safety of induction immunochemotherapy followed by definitive chemoradiotherapy (CRT) for unresectable locally advanced non‐small cell lung cancer (LA‐NSCLC). We identified unresectable stage III NSCLC patients who received induction immunochemotherapy. Overall survival (OS) and progression‐free survival (PFS) were the primary endpoints. From February 2019 to August 2022, 158 patients were enrolled. Following the completion of induction immunochemotherapy, the objective response rate (ORR) and disease control rate (DCR) were 52.5% and 83.5%, respectively. The ORR of CRT was 73.5%, representing 68.4% of the total cohort. The median PFS was 17.8 months, and the median OS was 41.9 months, significantly higher than in patients who received CRT alone (p < 0.001). Patients with concurrent CRT demonstrated markedly improved PFS (p = 0.012) and OS (p = 0.017) than those undergoing sequential CRT. Additionally, those with a programmed‐death ligand 1 (PD‐L1) expression of 50% or higher showed significantly elevated ORRs (72.2% vs. 47.2%, p = 0.011) and superior OS (median 44.8 vs. 28.6 months, p = 0.004) compared to patients with PD‐L1 expression below 50%. Hematologic toxicities were the primary severe adverse events (grade ≥ 3) encountered, with no unforeseen treatment‐related toxicities. Thus, induction immunochemotherapy followed by definitive CRT demonstrated encouraging efficacy and tolerable toxicities for unresectable LA‐NSCLC. |
| first_indexed | 2024-04-24T15:43:27Z |
| format | Article |
| id | doaj.art-1108e4ea86cb4177a9898ac66fadcb94 |
| institution | Directory Open Access Journal |
| issn | 2688-2663 |
| language | English |
| last_indexed | 2024-04-24T15:43:27Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | MedComm |
| spelling | doaj.art-1108e4ea86cb4177a9898ac66fadcb942024-04-01T16:35:36ZengWileyMedComm2688-26632024-03-0153n/an/a10.1002/mco2.501Induction immunochemotherapy followed by definitive chemoradiotherapy for unresectable locally advanced non‐small cell lung cancer: a multi‐institutional retrospective cohort studyLeilei Wu0Bo Cheng1Xiaojiang Sun2Zhenshan Zhang3Jingjing Kang4Yun Chen5Qinghua Xu6Shuangyan Yang7Yujie Yan8Shengxiang Ren9Caicun Zhou10Yaping Xu11Department of Radiation Oncology Shanghai Pulmonary Hospital School of Medicine Tongji University Shanghai ChinaDepartment of Radiation Oncology Qilu Hospital Cheeloo College of Medicine Shandong University Jinan ChinaDepartment of Radiation Oncology Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital) Institute of Cancer and Basic Medicine (IBMC) Chinese Academy of Sciences Hangzhou ChinaDepartment of Radiation Oncology Shanghai Proton and Heavy Ion Center Fudan University Cancer Hospital Shanghai ChinaDepartment of Radiation Oncology Shanghai Pulmonary Hospital School of Medicine Tongji University Shanghai ChinaDepartment of Radiation Oncology Shanghai Pulmonary Hospital School of Medicine Tongji University Shanghai ChinaDepartment of Radiation Oncology Shanghai Pulmonary Hospital School of Medicine Tongji University Shanghai ChinaDepartment of Radiation Oncology Shanghai Pulmonary Hospital School of Medicine Tongji University Shanghai ChinaDepartment of Radiation Oncology Shanghai Pulmonary Hospital School of Medicine Tongji University Shanghai ChinaDepartment of Medical Oncology Shanghai Pulmonary Hospital School of Medicine Tongji University Shanghai ChinaDepartment of Medical Oncology Shanghai Pulmonary Hospital School of Medicine Tongji University Shanghai ChinaDepartment of Radiation Oncology Shanghai Pulmonary Hospital School of Medicine Tongji University Shanghai ChinaAbstract This study aimed to evaluate the efficacy and safety of induction immunochemotherapy followed by definitive chemoradiotherapy (CRT) for unresectable locally advanced non‐small cell lung cancer (LA‐NSCLC). We identified unresectable stage III NSCLC patients who received induction immunochemotherapy. Overall survival (OS) and progression‐free survival (PFS) were the primary endpoints. From February 2019 to August 2022, 158 patients were enrolled. Following the completion of induction immunochemotherapy, the objective response rate (ORR) and disease control rate (DCR) were 52.5% and 83.5%, respectively. The ORR of CRT was 73.5%, representing 68.4% of the total cohort. The median PFS was 17.8 months, and the median OS was 41.9 months, significantly higher than in patients who received CRT alone (p < 0.001). Patients with concurrent CRT demonstrated markedly improved PFS (p = 0.012) and OS (p = 0.017) than those undergoing sequential CRT. Additionally, those with a programmed‐death ligand 1 (PD‐L1) expression of 50% or higher showed significantly elevated ORRs (72.2% vs. 47.2%, p = 0.011) and superior OS (median 44.8 vs. 28.6 months, p = 0.004) compared to patients with PD‐L1 expression below 50%. Hematologic toxicities were the primary severe adverse events (grade ≥ 3) encountered, with no unforeseen treatment‐related toxicities. Thus, induction immunochemotherapy followed by definitive CRT demonstrated encouraging efficacy and tolerable toxicities for unresectable LA‐NSCLC.https://doi.org/10.1002/mco2.501definitive chemoradiotherapyInduction immunochemotherapysurvivalunresectable LA‐NSCLC |
| spellingShingle | Leilei Wu Bo Cheng Xiaojiang Sun Zhenshan Zhang Jingjing Kang Yun Chen Qinghua Xu Shuangyan Yang Yujie Yan Shengxiang Ren Caicun Zhou Yaping Xu Induction immunochemotherapy followed by definitive chemoradiotherapy for unresectable locally advanced non‐small cell lung cancer: a multi‐institutional retrospective cohort study MedComm definitive chemoradiotherapy Induction immunochemotherapy survival unresectable LA‐NSCLC |
| title | Induction immunochemotherapy followed by definitive chemoradiotherapy for unresectable locally advanced non‐small cell lung cancer: a multi‐institutional retrospective cohort study |
| title_full | Induction immunochemotherapy followed by definitive chemoradiotherapy for unresectable locally advanced non‐small cell lung cancer: a multi‐institutional retrospective cohort study |
| title_fullStr | Induction immunochemotherapy followed by definitive chemoradiotherapy for unresectable locally advanced non‐small cell lung cancer: a multi‐institutional retrospective cohort study |
| title_full_unstemmed | Induction immunochemotherapy followed by definitive chemoradiotherapy for unresectable locally advanced non‐small cell lung cancer: a multi‐institutional retrospective cohort study |
| title_short | Induction immunochemotherapy followed by definitive chemoradiotherapy for unresectable locally advanced non‐small cell lung cancer: a multi‐institutional retrospective cohort study |
| title_sort | induction immunochemotherapy followed by definitive chemoradiotherapy for unresectable locally advanced non small cell lung cancer a multi institutional retrospective cohort study |
| topic | definitive chemoradiotherapy Induction immunochemotherapy survival unresectable LA‐NSCLC |
| url | https://doi.org/10.1002/mco2.501 |
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