Magnolia Ark team compiled | At present, the most important method for non-small cell lung cancer is still surgical resection. However, for middle- and advanced non-small cell lung cancer, the tumor may not be eradicated due to factors such as the size and location of the tumor. The emergence of neoadjuvant therapy provides the possibility for the cure of middle- and advanced non-small cell lung cancer. In recent years, several studies have confirmed that immunotherapy as a neoadjuvant treatment can improve the cure rate of middle- and advanced lung cancer.
Note: Neoadjuvant treatment refers to systemic treatment before local treatment methods (such as surgery or radiotherapy). The purpose is to reduce the lump and kill invisible metastatic cells as early as possible to facilitate subsequent surgery, radiotherapy and other treatments.
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Nature Sub-Issue: Tecentriq is safe and effective in treating non-small cell lung cancer
htmlOn September 12, a study published in the Nature sub-Issue "nature medicine" evaluated the effect of Tecentriq (Atezolizumab) as a neoadjuvant therapy for the treatment of stage IB-IIIB non-small cell lung cancer.
▲Photo source: Reference source [1]
The study included 181 patients with non-small cell lung cancer without treatment, stage IB-IIIB, and lesions resectable. The results showed that Tecentriq was effective as neoadjuvant treatment, with the main pathological reaction (MPR; surviving malignant cells ≤10%) of at 20%, with a 3-year survival rate of up to 80% , and no serious adverse reactions occurred.
Opdivo combined with chemotherapy as a neoadjuvant therapy to improve the pathological remission rate of more than ten times
In March this year, the US FDA approved the combination of the blockbuster PD-1 inhibitor Opdivo (nivolumab, nivolumab) with platinum-containing dual-drug chemotherapy as a neoadjuvant therapy to treat patients with non-small cell lung cancer (NSCLC), regardless of the patient's PD-L1 expression. Opdivo combined with chemotherapy is the first immunotherapy combination approved for the treatment of non-small cell lung cancer before surgery.
▲Photo source: Reference source [2]
The results of the study published in the New England Journal of Medicine (NEJM) in May this year showed that the median survival of for resectable lung cancer using Opdivo as a neoadjuvant treatment regimen was 31.6 months , and 20.8 months in the chemotherapy group; Opdiv The 1-year and 2-year event-free survival rates in group o group were 76.1%, 63.8% , respectively, while the control group was 63.4% and 45.3%; the proportion of patients in Opdivo group had surgery was 83.2%, and the chemotherapy group was only 75.4% ; the complete pathological response rate in Opdivo group was 24.0% , and the chemotherapy group was only 2.2%, and the increased by more than ten times .
▲Photo source: Reference source [3]
IMFinzi as perioperative therapy significantly improves lung cancer remission rate
Previously, the AEGEAN phase 3 clinical trial evaluated the effect of Imfinzi as perioperative therapy in patients with resectable stage IIA-IIIB non-small cell lung cancer. Data show that before surgery in patients with non-small cell lung cancer, PD-L1 antibody Imfinzi (durvalumab) combined with neoadjuvant chemotherapy can significantly reduce tumor cells visible in the resection tissue of patients, and improves pathology complete remission (pCR) in patients.
▲Photo source: Reference source [4]
In addition to immunotherapy, targeted therapies such as osimertinib and erlotinib have also shown outstanding effects in the field of neoadjuvant therapy for non-small cell lung cancer.
In short, the emergence of neoadjuvant therapy has brought the possibility of cure for patients with middle and advanced lung cancer. However, different lung cancer patients have different conditions and physical conditions. Whether they can benefit from neoadjuvant therapy combined surgery still needs to be determined by comprehensive evaluation of the patient's condition by lung cancer surgical treatment experts with rich surgical experience and skilled skills.
If you or your friends are also suffering from the threat or trouble of lung cancer, you hope to make an appointment with an authoritative expert to get more effective medical advice. You can contact the editor through private messages or comments.
Reference source:
[1]Neoadjuvant atezolizumab for resectable non-small cell lung cancer: an open-label, single-arm phase II trial | Nature Medicine
https://www.nature.com/articles/s41591-022-01962-5
[2]U.S. Food and Drug Administration Approves Opdivo® (nivolumab) with Chemotherapy as Neoadjuvant Treatment for Certain Adult Patients with Resectable Non-Small Cell Lung Cancer | Business Wire https://www.businesswire.com/news/home/20220301006264/en
[3]Neoadjuvant Nivolumab plus Chemotherapy in Resectable Lung Cancer | NEJM
https://www.nejm.org/doi/full/10.1056/NEJMoa2202170
[4]IMFINZI® (durvalumab) plus chemotherapy significantly improved pathology complete response in AEGEAN Phase III trial in resectable non-small cell lung cancer
https://www.astrazeneca-us.com/content/az-us/media/press-releases/2022/imfinzi-plus-chemotherapy-significantly-improved-pathologic-complete-response-in-aegean-phaseIII-trial-in-resectable-non-small-cell-lung-cancer.html
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