Real-world treatment patterns and outcomes with induction chemoimmunotherapy as bridge to definitive local therapy for nonmetastatic NSCLC

Induction chemoimmunotherapy is increasingly used for select early-stage and locally advanced NSCLC, but real-world treatment patterns and outcomes are poorly defined. A retrospective analysis of 168 stage I-III NSCLC patients at MD Anderson Cancer Center (Houston, TX) investigated these endpoints. Among these patients, 72 (43%) were clinical stage III, 144 (86%) were surgical candidates at baseline, and 6 (4%) experienced disease progression during induction chemoimmunotherapy. Following induction chemoimmunotherapy, 115 (68%, or 80% of baseline surgical candidates) underwent surgical resection, 44 (26%) received fractionated radiotherapy (FRT) as either conventional fractionation with chemotherapy (n=30) or hypofractionations without chemotherapy (n=14), 4 (2%) received SBRT, and 5 (3%) did not receive definitive local therapy. Maintenance immunotherapy was started for 29% of post-surgical patients and 61% of post-FRT patients, although its use was not associated with significant improvements in overall survival or progression-free survival. OS and PFS also did not differ between FRT regimens. The authors conclude that these findings demonstrate that induction chemoimmunotherapy is being adopted across a broad NSCLC population and can effectively bridge patients to various definitive therapy strategies.