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
. 2024 May;25(3):e133-e144.e4.
doi: 10.1016/j.cllc.2023.12.005. Epub 2023 Dec 19.

Transitioning to Neoadjuvant Therapy for Resectable Non-Small Cell Lung Cancer: Trends and Surgical Outcomes in a Regionalized Pulmonary Oncology Network

Yohann Pilon  1 , Merav Rokah  1 , Joseph Seitlinger  1 , Boris Sepesi  2 , Roni F Rayes  3 , Jonathan Cools-Lartigue  1 , Sara Najmeh  1 , Christian Sirois  1 , David Mulder  1 , Lorenzo Ferri  1 , Bassam Abdulkarim  4 , Nicole Ezer  5 , Richard Fraser  6 , Sophie Camilleri-Broët  6 , Pierre-Olivier Fiset  6 , Annick Wong  7 , Shelly Sud  8 , Adrian Langleben  4 , Jason Agulnik  9 , Carmela Pepe  9 , Benjamin Shieh  4 , Vera Hirsh  4 , Linda Ofiara  4 , Scott Owen  4 , Jonathan D Spicer  10
Affiliations

Transitioning to Neoadjuvant Therapy for Resectable Non-Small Cell Lung Cancer: Trends and Surgical Outcomes in a Regionalized Pulmonary Oncology Network

Yohann Pilon et al. Clin Lung Cancer. 2024 May.

Abstract

Background: Several regulatory agencies have approved the use of the neoadjuvant chemo-immunotherapy for resectable stage II and III of non-small cell lung cancer (NSCLC) and numerous trials investigating novel agents are underway. However, significant concerns exist around the feasibility and safety of offering curative surgery to patients treated within such pathways. The goal in this study was to evaluate the impact of a transition towards a large-scale neoadjuvant therapy program for NSCLC.

Methods: Medical charts of patients with clinical stage II and III NSCLC who underwent resection from January 2015 to December 2020 were reviewed. The primary outcome was perioperative complication rate between neoadjuvant-treated versus upfront surgery patients. Multivariable logistic regression estimated occurrence of postoperative complications and overall survival was assessed as an exploratory secondary outcome by Kaplan-Meier and Cox-regression analyses.

Results: Of the 428 patients included, 106 (24.8%) received neoadjuvant therapy and 322 (75.2%) upfront surgery. Frequency of minor and major postoperative complications was similar between groups (P = .22). Occurrence in postoperative complication was similar in both cohort (aOR = 1.31, 95% CI 0.73-2.34). Neoadjuvant therapy administration increased from 10% to 45% with a rise in targeted and immuno-therapies over time, accompanied by a reduced rate of preoperative radiation therapy use. 1-, 2-, and 5-year overall survival was higher in neoadjuvant therapy compared to upfront surgery patients (Log-Rank P = .017).

Conclusions: No significant differences in perioperative outcomes and survival were observed in resectable NSCLC patients treated by neoadjuvant therapy versus upfront surgery. Transition to neoadjuvant therapy among resectable NSCLC patients is safe and feasible from a surgical perspective.

Keywords: Locally advanced non-small cell lung cancer; Perioperative outcomes; Personalized medicine; Preoperative therapies; Thoracic oncology.

PubMed Disclaimer

Conflict of interest statement

Disclosure JDS has received honoraria and consulting fees from Roche, Merck, BMS, AstraZeneca, Regeneron, Novartis, Protalix Biotherapeutics, Xenetic Biosciences and Protalix Biotherapeutics. JS also received grants to his institution from Roche, AstraZeneca, Protalix Biotherapeutics, CLS Therapeutics, BMS and Merck. BS received speakers’ fees from AstraZeneca, Medscape, and PEER VIEW, and consulting fees from AstraZeneca. SO received honoraria from Astra Zeneca, Bayer, BMS, and Novocure.

MeSH terms