Phase 2 trial of neoadjuvant chemo-immunotherapy for potentially resectable stage IIIA or IIIB non-small cell lung cancer

Information regarding the effectiveness of neoadjuvant immunotherapy for potentially resectable stage IIIA/IIIB non-small cell lung cancer is limited. The phase 2 Neo-Pre-IC trial at Jilin University (China) evaluated the neoadjuvant combination of sintilimab (anti-PD-1) with nab-paclitaxel and carboplatin for potentially resectable stage IIIA/IIIB NSCLC. 30 patients who were deemed unsuitable for R0 resection at initial diagnosis underwent two or three cycles of neoadjuvant chemoimmunotherapy. Among these patients, 20 underwent R0 resection. Major pathological response was seen in 65% and pathological complete response in 40%. The two-year disease-free survival rate among the surgical group was 75%. Three patients (10%) had grade 3 or higher immune-related adverse events, including one case of grade 5 bronchopleural fistula. The authors conclude that neoadjuvant chemoimmunotherapy markedly enhanced the rate of pathological response and two-year DFS in patients with potentially resectable IIIA/IIIB NSCLC.