Two-center real-world retrospective study of impact of G-CSF on neoadjuvant immunochemotherapy efficacy in NSCLC

Preclinical evidence suggests that colony-stimulating factors may modulate antitumor immunity. A real-world retrospective study at Sun Yat-sen University Cancer Center (Guangzhou, China) and Shantou University Medical College (Shantou, China) investigated the impact of granulocyte colony-stimulating factor (G-CSF) administration on efficacy of neoadjuvant immunochemotherapy (NICT) in non-small cell lung cancer (NSCLC) without known EGFR or ALK mutations. The study included 439 stage II-III NSCLC patients receiving NICT followed by R0 resection; 135 receiving G-CSF added to NICT and 304 control patients. G-CSF administration during NICT significantly improved pathological complete response (pCR) rates (39.8% versus 26.7%; p=0.011) with no significant impact on 2-year disease-free survival rate (DFS; 81% versus 79%; p>0.05). Propensity score matching (PSM, 1:1) yielded 114 matched pairs. In the PSM cohort, G-CSF administration significantly improved pCR rates (43.9% versus 28.1%; p=0.019) but not 2-year DFS (79% versus 75%; p>0.05). Multivariate analysis identified G-CSF as an independent factor for pCR in the PSM cohort (OR 2.09; p=0.011). The authors conclude that for NSCLC patients without EGFR or ALK mutations receiving NICT, G-CSF administration could enhance pCR rates.