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...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-03-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/17588359231163798 |
| _version_ | 1797858533599870976 |
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| author | Lanyi Nora Chen Alexander Z. Wei Catherine A. Shu |
| author_facet | Lanyi Nora Chen Alexander Z. Wei Catherine A. Shu |
| author_sort | Lanyi Nora Chen |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-09T21:14:55Z |
| format | Article |
| id | doaj.art-32366d520a7b420cae75df2841b19e0f |
| institution | Directory Open Access Journal |
| issn | 1758-8359 |
| language | English |
| last_indexed | 2024-04-09T21:14:55Z |
| publishDate | 2023-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-32366d520a7b420cae75df2841b19e0f2023-03-28T11:03:56ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592023-03-011510.1177/17588359231163798Neoadjuvant immunotherapy in resectable non-small-cell lung cancerLanyi Nora ChenAlexander Z. WeiCatherine A. ShuThe 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.https://doi.org/10.1177/17588359231163798 |
| spellingShingle | Lanyi Nora Chen Alexander Z. Wei Catherine A. Shu Neoadjuvant immunotherapy in resectable non-small-cell lung cancer Therapeutic Advances in Medical Oncology |
| 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 |
| url | https://doi.org/10.1177/17588359231163798 |
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