Multinational real-world retrospective study of neoadjuvant chemoimmunotherapy in squamous cell lung cancer

Squamous cell lung cancer (SqCLC) accounts for approximately 25% of non-small cell lung cancers. Neoadjuvant chemoimmunotherapy has been established as standard-of-care for resectable non-small cell lung cancer, but real-world data on safety and activity are limited. A retrospective study across 16 European countries evaluated neoadjuvant chemoimmunotherapy for resectable SqCLC. Of 127 patients, 88 had stage III disease (69.3%). Patients received a median of 3 chemoimmunotherapy cycles, most commonly carboplatin-paclitaxel-nivolumab (72.4%). Dose reductions and treatment discontinuation occurred in 26 (20.5%) and 10 (7.9%) patients, respectively. Seventy-nine patients (62.2%) experienced at least one adverse event, including 9 grade 3 immune-related adverse events. No chemoimmunotherapy deaths occurred. Objective response rate was 76.8%. Twenty-four patients did not undergo surgery, including 4 due to toxicity; subsequently, 9 received radical radiotherapy. Among 127 patients, pathological complete response rate and major pathological response rate were 41.7% and 63.8%, respectively; among 103 patients undergoing surgery corresponding rates were 51.5% and 78.3%. One-year event-free survival rate was 75.6%. Among patients not undergoing surgery, 58.3% experienced disease progression within one year and 37.5% died. The authors conclude that in this real-world cohort, neoadjuvant chemoimmunotherapy for resectable SqCLC was feasible with manageable toxicity and high pCR rates.