Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul 14;60(1):81-88.
doi: 10.1093/ejcts/ezab007.

Outcomes of surgical resection after neoadjuvant chemoimmunotherapy in locally advanced stage IIIA non-small-cell lung cancer

Alejandra Romero Román  1 , Jose Luis Campo-Cañaveral de la Cruz  1 , Iván Macía  1 , Ignacio Escobar Campuzano  1   2   3 , Santiago Figueroa Almánzar  4 , María Delgado Roel  5 , Carlos Gálvez Muñoz  6 , Eva M García Fontán  7 , Ignacio Muguruza Trueba  8 , Laura Romero Vielva  9 , José Ramón Cano Garcia  10 , Elisabeth Martínez Téllez  11 , Concepción Partida González  12 , Marcelo Fernando Jiménez López  13 , Unai Jiménez Maestre  14 , Roberto Mongil Poce  15 , David Sánchez Lorente  16 , Antonio Álvarez Kindelán  17 , Mariano Provencio Pulla  18
Affiliations

Outcomes of surgical resection after neoadjuvant chemoimmunotherapy in locally advanced stage IIIA non-small-cell lung cancer

Alejandra Romero Román et al. Eur J Cardiothorac Surg. .

Abstract

Objectives: This analysis aimed to evaluate perioperative outcomes of surgical resection following neoadjuvant treatment with chemotherapy plus nivolumab in resectable stage IIIA non-small-cell lung cancer.

Methods: Eligible patients received neoadjuvant chemotherapy (paclitaxel + carboplatin) plus nivolumab for 3 cycles. Reassessment of the tumour was carried out after treatment and patients with at least stable disease as best response underwent pulmonary resection. After surgery, patients received adjuvant treatment with nivolumab for 1 year. Surgical data were collected from the NADIM database and patient charts were reviewed for additional surgical details.

Results: Among 46 patients who received neoadjuvant treatment, 41 (89.1%) underwent surgery. Two patients rejected surgery and 3 did not fulfil resectability criteria. There were 35 lobectomies (85.3%), 3 of which were sleeve lobectomies (9.4%), 3 bilobectomies (7.3%) and 3 pneumonectomies (7.3%). Video-assisted thoracoscopy was the initial approach in 51.2% of cases, with a conversion rate of 19% (n = 4). There was no operative mortality at either 30 or 90 days. The most common complications were prolonged air leak (n = 8), pneumonia (n = 5) and arrhythmia (n = 4). Complete resection (R0) was achieved in all patients who underwent surgery, downstaging was observed in 37 patients (90.2%) and major pathological response in 34 patients (82.9%).

Conclusions: Surgical resection following induction therapy with chemotherapy plus nivolumab appears to be safe and offers appropriate oncological outcomes. Perioperative morbidity and mortality rates in our study were no higher than previously reported in this setting. A minimally invasive approach is, therefore, feasible.

Trial registration: ClinicalTrials.gov NCT02998525 NCT03456063 NCT03425643.

Keywords: Chemotherapy; Immunotherapy; Locally advanced non-small-cell lung cancer; Post induction surgery.

PubMed Disclaimer

Publication types

MeSH terms

Associated data