Retrospective study of addition of immunotherapy to perioperative chemotherapy for stage II-IIIB pulmonary lymphoepithelioma-like carcinoma

Primary pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare subtype of non-small cell lung cancer. A retrospective study at State Key Laboratory of Oncology in South China (Guangzhou) evaluated addition of PD-1/PD-L1 inhibitor to perioperative chemotherapy for resectable stage II-IIIB PLELC. The study included 48 patients who received perioperative chemotherapy alone (chemo group) and 24 patients who received perioperative PD-1/PD-l1 plus chemotherapy (IO-chemo group). Major pathologic response was seen in 54.2% in the IO-chemo group versus 12.5% in the chemo group (OR 1.91; p<0.001) whereas pathologic complete response was seen in 33.3% versus 4.2% (OR 1.44; p=0.002). Median event-free survival was not reached in the IO-chemo group and was 35.0 months in the chemo group (HR 0.42; p=0.0031). In multivariate analysis, addition of PD-1/PD-L1 to perioperative chemotherapy was independently associated with longer EFS (HR 0.32; p=0.043). Adverse event of any grade occurred in 91.7% of patients in the IO-chemo group and 89.6% of patients in the chemo group. The authors conclude that in patients with resectable PLELC, addition of PD-1/PD-L1 inhibitor to perioperative chemotherapy resulted in improved EFS and percentage of patients achieving MPR and pCR.