Survival impact of adjuvant immunotherapy after neoadjuvant immunotherapy for stage II-IIIB non-small cell lung cancer

Neoadjuvant immunotherapy (neoadj-IO) is the standard of care for resectable non-small cell lung cancer (NSCLC). The impact of adjuvant immunotherapy (adj-IO) is not yet clear. A retrospective study at Southern Medical University (Guangzhou, China) investigated the survival impact of adj-IO among patients who received neoadj-IO for stage II-IIIB NSCLC followed by complete resection. The study included 267 patients (median age 60 years; range 25-85; 168 male). After 1:1 propensity score matching two groups were formed of 102 patients each who received or did not receive adj-IO. Addition of adj-IO did not impact disease-free survival (DFS; HR 1.11; p=0.705) or overall survival (OS; HR 0.47; p=0.070). In subgroup analyses, adj-IO did not improve DFS or OS in terms of pathological response, PD-L1 expression level (0% versus others), or histological subgroup (adenocarcinoma versus others). Adj-IO was not an independent prognostic factor for DFS (p=0.427) or OS (p=0.210). The authors conclude that adj-IO may have no impact on survival after neoadj-IO and complete resection for stage II-IIIB NSCLC.