Clinical factors and major pathological response after neoadjuvant chemoimmunotherapy in potentially resectable lung squamous cell carcinoma
ObjectiveMajor pathological response (MPR) helps evaluate the prognosis of patients with lung squamous cell carcinoma (LUSC). However, the clinical factors that affect the achievement of MPR after neoadjuvant chemoimmunotherapy (NCIO) in patients with LUSC remain unclear. This study aimed to explore...
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Frontiers Media S.A.
2024-04-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1265228/full |
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| author | Ye Wang Ye Wang Yingqiu Song Runze Wang Yu Wu Yu Wu Mo Li Ke Xu Rong He Zheng Wang Qingqing Li Feng-Ming (Spring) Kong Feng-Ming (Spring) Kong Tianlu Wang Tianlu Wang |
| author_facet | Ye Wang Ye Wang Yingqiu Song Runze Wang Yu Wu Yu Wu Mo Li Ke Xu Rong He Zheng Wang Qingqing Li Feng-Ming (Spring) Kong Feng-Ming (Spring) Kong Tianlu Wang Tianlu Wang |
| author_sort | Ye Wang |
| collection | DOAJ |
| description | ObjectiveMajor pathological response (MPR) helps evaluate the prognosis of patients with lung squamous cell carcinoma (LUSC). However, the clinical factors that affect the achievement of MPR after neoadjuvant chemoimmunotherapy (NCIO) in patients with LUSC remain unclear. This study aimed to explore the clinical factors affecting the MPR after NCIO in patients with potentially resectable LUSC.MethodsThis retrospective study included patients with stage IIB-IIIC LUSC who underwent surgical resection after receiving NCIO at a center between March 2020 and November 2022. In addition to the postoperative pathological remission rate, sex, age, body mass index (BMI), smoking history, TNM stage, hematological and imaging test results, and other indicators were examined before NCIO. According to the pathological response rate of the surgically removed tumor tissue, the patients were split into MPR and non-MPR groups.ResultsIn total, 91 LUSC patients who met the study’s eligibility criteria were enrolled: 32 (35%) patients in the non-MPR group and 59 (65%) in the MPR group, which included 43 cases of pathological complete remission (pCR). Pre-treatment lymphocyte level (LY) (odds ratio [OR] =5.997), tumor burden (OR=0.958), N classification (OR=15.915), radiographic response (OR=11.590), pulmonary atelectasis (OR=5.413), and PD-L1 expression (OR=1.028) were independently associated with MPR (all P < 0.05). Based on these six independent predictors, we developed a nomogram model of prediction having an area under the curve (AUC) of 0.914 that is simple to apply clinically to predict the MPR. The MPR group showed greater disease-free survival (DFS) than the non-MPR group, according to the survival analysis (P < 0.001).ConclusionThe MPR rate of NCIO for potentially resectable LUSC was 65%. LY, tumor burden, N classification, radiographic response, pulmonary atelectasis, and PD-L1 expression in patients with LUSC before NCIO were the independent and ideal predictors of MPR. The developed nomogram demonstrated a good degree of accuracy and resilience in predicting the MPR following NCIO, indicating that it is a useful tool for assuring customized therapy for patients with possibly resectable LUSC. |
| first_indexed | 2024-04-24T10:58:50Z |
| format | Article |
| id | doaj.art-acf10aeacae24c94a1a2b12232390fa5 |
| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-04-24T10:58:50Z |
| publishDate | 2024-04-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-acf10aeacae24c94a1a2b12232390fa52024-04-12T04:27:00ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-04-011410.3389/fonc.2024.12652281265228Clinical factors and major pathological response after neoadjuvant chemoimmunotherapy in potentially resectable lung squamous cell carcinomaYe Wang0Ye Wang1Yingqiu Song2Runze Wang3Yu Wu4Yu Wu5Mo Li6Ke Xu7Rong He8Zheng Wang9Qingqing Li10Feng-Ming (Spring) Kong11Feng-Ming (Spring) Kong12Tianlu Wang13Tianlu Wang14Department of Radiotherapy, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, Shenyang, Liaoning, ChinaSchool of Graduate, Dalian Medical University, Dalian, ChinaDepartment of Radiotherapy, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, Shenyang, Liaoning, ChinaDepartment of Radiotherapy, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, Shenyang, Liaoning, ChinaDepartment of Radiotherapy, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, Shenyang, Liaoning, ChinaSchool of Graduate, Dalian Medical University, Dalian, ChinaDepartment of Breast Surgery, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, ChinaDepartment of Thoracic Surgery, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, ChinaDepartment of Thoracic Surgery, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, ChinaDepartment of Thoracic Surgery, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, ChinaDepartment of Endoscopy, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, ChinaDepartment of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, ChinaDepartment of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaDepartment of Radiotherapy, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, Shenyang, Liaoning, ChinaFaculty of Medicine, Dalian University of Technology, Dalian, ChinaObjectiveMajor pathological response (MPR) helps evaluate the prognosis of patients with lung squamous cell carcinoma (LUSC). However, the clinical factors that affect the achievement of MPR after neoadjuvant chemoimmunotherapy (NCIO) in patients with LUSC remain unclear. This study aimed to explore the clinical factors affecting the MPR after NCIO in patients with potentially resectable LUSC.MethodsThis retrospective study included patients with stage IIB-IIIC LUSC who underwent surgical resection after receiving NCIO at a center between March 2020 and November 2022. In addition to the postoperative pathological remission rate, sex, age, body mass index (BMI), smoking history, TNM stage, hematological and imaging test results, and other indicators were examined before NCIO. According to the pathological response rate of the surgically removed tumor tissue, the patients were split into MPR and non-MPR groups.ResultsIn total, 91 LUSC patients who met the study’s eligibility criteria were enrolled: 32 (35%) patients in the non-MPR group and 59 (65%) in the MPR group, which included 43 cases of pathological complete remission (pCR). Pre-treatment lymphocyte level (LY) (odds ratio [OR] =5.997), tumor burden (OR=0.958), N classification (OR=15.915), radiographic response (OR=11.590), pulmonary atelectasis (OR=5.413), and PD-L1 expression (OR=1.028) were independently associated with MPR (all P < 0.05). Based on these six independent predictors, we developed a nomogram model of prediction having an area under the curve (AUC) of 0.914 that is simple to apply clinically to predict the MPR. The MPR group showed greater disease-free survival (DFS) than the non-MPR group, according to the survival analysis (P < 0.001).ConclusionThe MPR rate of NCIO for potentially resectable LUSC was 65%. LY, tumor burden, N classification, radiographic response, pulmonary atelectasis, and PD-L1 expression in patients with LUSC before NCIO were the independent and ideal predictors of MPR. The developed nomogram demonstrated a good degree of accuracy and resilience in predicting the MPR following NCIO, indicating that it is a useful tool for assuring customized therapy for patients with possibly resectable LUSC.https://www.frontiersin.org/articles/10.3389/fonc.2024.1265228/fulllung squamous cell carcinomaneoadjuvant chemoimmunotherapymajor pathologic responsenomogrambiomarkers |
| spellingShingle | Ye Wang Ye Wang Yingqiu Song Runze Wang Yu Wu Yu Wu Mo Li Ke Xu Rong He Zheng Wang Qingqing Li Feng-Ming (Spring) Kong Feng-Ming (Spring) Kong Tianlu Wang Tianlu Wang Clinical factors and major pathological response after neoadjuvant chemoimmunotherapy in potentially resectable lung squamous cell carcinoma Frontiers in Oncology lung squamous cell carcinoma neoadjuvant chemoimmunotherapy major pathologic response nomogram biomarkers |
| title | Clinical factors and major pathological response after neoadjuvant chemoimmunotherapy in potentially resectable lung squamous cell carcinoma |
| title_full | Clinical factors and major pathological response after neoadjuvant chemoimmunotherapy in potentially resectable lung squamous cell carcinoma |
| title_fullStr | Clinical factors and major pathological response after neoadjuvant chemoimmunotherapy in potentially resectable lung squamous cell carcinoma |
| title_full_unstemmed | Clinical factors and major pathological response after neoadjuvant chemoimmunotherapy in potentially resectable lung squamous cell carcinoma |
| title_short | Clinical factors and major pathological response after neoadjuvant chemoimmunotherapy in potentially resectable lung squamous cell carcinoma |
| title_sort | clinical factors and major pathological response after neoadjuvant chemoimmunotherapy in potentially resectable lung squamous cell carcinoma |
| topic | lung squamous cell carcinoma neoadjuvant chemoimmunotherapy major pathologic response nomogram biomarkers |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1265228/full |
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