Multicenter real-world study of adjuvant therapy after pathologic complete response to neoadjuvant immunochemotherapy in non-small cell lung cancer

It is not clear whether resectable stage II to IIIB non-small cell lung cancer (NSCLC) patients could benefit from adjuvant therapy when pathologic complete response (pCR) is achieved after neoadjuvant immunochemotherapy. A multicenter real-world retrospective study in China included 214 such patients; 133 received adjuvant therapy and 81 underwent surveillance. The primary outcome was disease-free survival (DFS). During a median follow-up of 29.5 months, 25 patients experienced recurrence, and 11 died. After propensity score matching two groups of 74 patients each were included. In the matched cohort, adjuvant therapy was not associated with improved DFS (HR 1.22; 95% CI 0.51-2.95) or overall survival (1.00; 0.20-4.96) compared with surveillance alone. Grade 3 or higher treatment-related adverse events were observed in 18% of patients who received adjuvant therapy. The authors conclude that in stage II-IIIB NSCLC patients achieving pCR after neoadjuvant immunochemotherapy, adjuvant therapy was not associated with improved outcomes, but was associatedwith treatment-related toxicity.