Induction immune-checkpoint inhibitors for resectable oncogene-mutant NSCLC: A multicenter pooled analysis
Chao Zhang, Hua-Fei Chen, Shi Yan, Lin Wu, Li-Xu Yan, Xiao-Long Yan, Dong-Sheng Yue, Chun-Wei Xu, Min Zheng, Ji-Sheng Li, Si-Yang Liu, Ling-Ling Yang, Ben-Yuan Jiang, Qiu-Xiang Ou, Zhen-Bin Qiu, Yang Shao, Yi-Long Wu, Wen-Zhao Zhong, Chao Zhang, Hua-Fei Chen, Shi Yan, Lin Wu, Li-Xu Yan, Xiao-Long Yan, Dong-Sheng Yue, Chun-Wei Xu, Min Zheng, Ji-Sheng Li, Si-Yang Liu, Ling-Ling Yang, Ben-Yuan Jiang, Qiu-Xiang Ou, Zhen-Bin Qiu, Yang Shao, Yi-Long Wu, Wen-Zhao Zhong
Abstract
Despite limited efficacy of immunotherapy for advanced non-small-cell lung cancer (NSCLC) with driver mutations, whether neoadjuvant immunotherapy could be clinically valuable in those patients warrants further investigation. We utilized 40 oncogene-mutant NSCLC treated with induction immunotherapy from a large consecutive multicenter cohort. Overall response rate was 62.5% while 2 patients had disease progression. Of 39 patients that received surgery, R0 resection rate was 97.4%. The major pathological response (MPR) rate was 37.5% and the pathological complete response (pCR) rate was 12.5%. Pre-treatment PD-L1 expression was not a predictive biomarker in these patients. Median disease-free survival for all oncogenic mutation and EGFR mutation was 28.5 months. Indirect comparison through integrating CTONG1103 cohort showed neoadjuvant immunotherapy plus chemotherapy yielded the most superior efficacy among erlotinib and chemotherapy for resectable EGFR-mutant NSCLC. No MPR patients were identified with neoadjuvant immunotherapy plus chemotherapy for uncommon EGFR insertion or point mutations. Our results indicated the potential clinical feasibility of neoadjuvant immunotherapy for resectable localized oncogene-mutant NSCLC especially for EGFR-mutant NSCLC.
Conflict of interest statement
W.-Z.Z. received speech honoraria from AstraZeneca, Roche, Eli Lilly, and Pfizer. Y.-L.W. received research funding from Roche and speech honoraria from AstraZeneca, Roche, Eli Lilly, Pfizer and Sanofi, and he was a research consultant for AstraZeneca. L.W. and D.S.Y. received speech honoraria from AstraZeneca and Roche. L.-L.Y., Q.-X.O., and Y.S. are employees of Nanjing Geneseeq Technology Inc. The remaining authors declare no conflict of interest.
© 2022. The Author(s).
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