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Observational Study
. 2025:43:100910.
doi: 10.1016/j.ctarc.2025.100910. Epub 2025 Apr 3.

Analysis of operability parameter changes in neoadjuvant treatment with chemotherapy and anti-PD-1/PD-L1

M Sereno  1 , A Collazo-Lorduy  2 , Y Garitaonaindia  2 , D Gómez de Antonio  3 , J Baena Espinar  4 , C Aguado de la Rosa  5 , P Cruz Castellanos  6 , S Falagán Martínez  7 , L E Chara Valverde  8 , R López-Castro  9 , A López-Martin  10 , J Rubio-Pérez  11 , A Gómez Rueda  12 , C Traseira Puchol  13 , X Mielgo Rubio  14 , B Losada Vila  15 , J Rogado  16 , E Bernal Hertfelder  17 , L Gutiérrez Sainz  18 , J L Campo-Cañaveral  19 , I Romano  20 , I Thuissard  21 , G Rubio Romero  21 , E Casado Sáenz  22
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Free article
Observational Study

Analysis of operability parameter changes in neoadjuvant treatment with chemotherapy and anti-PD-1/PD-L1

M Sereno et al. Cancer Treat Res Commun. 2025.
Free article

Abstract

Background: The adoption of combined chemotherapy (CT) and immunotherapy (IO) has advanced neoadjuvant therapy (NA) for non-small cell lung cancer (NSCLC), but data on functional impacts are limited. This multicenter retrospective study evaluates respiratory function in NSCLC patients undergoing NA.

Methods: From 2020 to 2024, 186 patients treated with CT or CT-IO (anti-PD-1/PD-L1) were analyzed. Respiratory tests (DLCO, FEV1, FVC) pre- and post-NA were compared, alongside clinical, pathological, and surgical variables.

Results: Median age: 68; 66.6 % male; 93 % smokers/ex-smokers, histologies: Squamous and adenocarcinoma (46 % each), DLCO decline was greater in CT-IO vs. CT (-12.6 % vs. -7.8 %, p = 0.007) and CT-IO showed increased FEV1 (+3.8 % vs. -2.5 %, p = 0.001) and FVC (+3.7 % vs. -0.7 %, p = 0.003), surgery rate: 85.7 % (lobectomy most common at 83.3 %) and no differences in complications were found except for 9 immune-mediated events in CT-IO.

Conclusions: CT-IO impacts DLCO more but improves FEV1 and FVC compared to CT. These findings warrant further validation in prospective studies.

Keywords: Chemo-inmunotherapy; DLCO; Neoadjuvant; Operability.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The author is an Editorial Board Member/Editor-in-Chief/Associate Editor/Guest Editor for this journal and was not involved in the editorial review or the decision to publish this article.

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