Comparative Efficacy of PD‐1 Inhibitor‐Based Neoadjuvant Chemoimmunotherapy Regimens for Resectable Stage II–IIIa NSCLC: A Real‐World Retrospective Study

ABSTRACT Background Although neoadjuvant chemoimmunotherapy has emerged as a promising approach for resectable non‐small cell lung cancer (NSCLC), comparative real‐world data on different PD‐1 inhibitors are limited. This study compared the clinical efficacy, pathological response, survival, and saf...

Full description

Saved in:
Bibliographic Details
Main Authors: Bo Yan, Xiaoxuan Sun, Yan Sheng, Ran Zhang, Yanjun Su, Yulong Chen
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Thoracic Cancer
Subjects:
Online Access:https://doi.org/10.1111/1759-7714.70123
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849318850192998400
author Bo Yan
Xiaoxuan Sun
Yan Sheng
Ran Zhang
Yanjun Su
Yulong Chen
author_facet Bo Yan
Xiaoxuan Sun
Yan Sheng
Ran Zhang
Yanjun Su
Yulong Chen
author_sort Bo Yan
collection DOAJ
description ABSTRACT Background Although neoadjuvant chemoimmunotherapy has emerged as a promising approach for resectable non‐small cell lung cancer (NSCLC), comparative real‐world data on different PD‐1 inhibitors are limited. This study compared the clinical efficacy, pathological response, survival, and safety of four PD‐1 inhibitors—pembrolizumab, tislelizumab, camrelizumab, and sintilimab—in patients with Stage II–IIIa NSCLC. Methods We retrospectively reviewed 199 patients with resectable Stage II–IIIa NSCLC treated with neoadjuvant PD‐1 inhibitors plus platinum‐based chemotherapy from January 2018 to December 2024. After excluding 50 non‐surgical cases, 149 patients were included. Outcomes compared included pathological response (pathological complete response, pCR; major pathological response, MPR), recurrence, disease‐free survival (DFS), overall survival (OS), and adverse events. Results pCR and MPR rates were 52.2% and 58.0% (pembrolizumab), 67.6% and 75.7% (tislelizumab), 71.4% and 71.4% (camrelizumab), and 47.2% and 61.1% (sintilimab), respectively. Differences in pCR/MPR were not statistically significant. However, OS differed significantly across groups (p < 0.05), favoring pembrolizumab and tislelizumab. No significant differences were observed in progression‐free survival (PFS) or recurrence among patients with pCR. Grade ≥ 3 treatment‐related adverse events occurred in 27.0%–42.9% of patients, lowest in the tislelizumab group. Conclusion All treatment regimens elicited substantial pathological responses and exhibited acceptable safety profiles. Pembrolizumab and tislelizumab were associated with better OS and lower toxicity, supporting their preferential use in neoadjuvant therapy for resectable NSCLC.
format Article
id doaj-art-3cec4de8f4df4792b74a5995b8d9d536
institution Kabale University
issn 1759-7706
1759-7714
language English
publishDate 2025-07-01
publisher Wiley
record_format Article
series Thoracic Cancer
spelling doaj-art-3cec4de8f4df4792b74a5995b8d9d5362025-08-20T03:50:43ZengWileyThoracic Cancer1759-77061759-77142025-07-011613n/an/a10.1111/1759-7714.70123Comparative Efficacy of PD‐1 Inhibitor‐Based Neoadjuvant Chemoimmunotherapy Regimens for Resectable Stage II–IIIa NSCLC: A Real‐World Retrospective StudyBo Yan0Xiaoxuan Sun1Yan Sheng2Ran Zhang3Yanjun Su4Yulong Chen5Department of Radiotherapy National Clinical Research Center of Cancer, Tianjin Medical University Cancer Institute and Hospital Tianjin ChinaDepartment of Thoracic Cancer Tianjin Cancer Hospital Airport Hospital National Clinical Research Center for Cancer Tianjin ChinaDepartment of Pathology Tianjin Cancer Hospital Airport Hospital National Clinical Research Center for Cancer Tianjin ChinaDepartment of Thoracic Cancer Tianjin Cancer Hospital Airport Hospital National Clinical Research Center for Cancer Tianjin ChinaDepartment of Lung Cancer Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy Tianjin ChinaDepartment of Lung Cancer Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy Tianjin ChinaABSTRACT Background Although neoadjuvant chemoimmunotherapy has emerged as a promising approach for resectable non‐small cell lung cancer (NSCLC), comparative real‐world data on different PD‐1 inhibitors are limited. This study compared the clinical efficacy, pathological response, survival, and safety of four PD‐1 inhibitors—pembrolizumab, tislelizumab, camrelizumab, and sintilimab—in patients with Stage II–IIIa NSCLC. Methods We retrospectively reviewed 199 patients with resectable Stage II–IIIa NSCLC treated with neoadjuvant PD‐1 inhibitors plus platinum‐based chemotherapy from January 2018 to December 2024. After excluding 50 non‐surgical cases, 149 patients were included. Outcomes compared included pathological response (pathological complete response, pCR; major pathological response, MPR), recurrence, disease‐free survival (DFS), overall survival (OS), and adverse events. Results pCR and MPR rates were 52.2% and 58.0% (pembrolizumab), 67.6% and 75.7% (tislelizumab), 71.4% and 71.4% (camrelizumab), and 47.2% and 61.1% (sintilimab), respectively. Differences in pCR/MPR were not statistically significant. However, OS differed significantly across groups (p < 0.05), favoring pembrolizumab and tislelizumab. No significant differences were observed in progression‐free survival (PFS) or recurrence among patients with pCR. Grade ≥ 3 treatment‐related adverse events occurred in 27.0%–42.9% of patients, lowest in the tislelizumab group. Conclusion All treatment regimens elicited substantial pathological responses and exhibited acceptable safety profiles. Pembrolizumab and tislelizumab were associated with better OS and lower toxicity, supporting their preferential use in neoadjuvant therapy for resectable NSCLC.https://doi.org/10.1111/1759-7714.70123chemoimmunotherapyimmune checkpoint inhibitorsneoadjuvant therapynon‐small cell lung cancersurgery
spellingShingle Bo Yan
Xiaoxuan Sun
Yan Sheng
Ran Zhang
Yanjun Su
Yulong Chen
Comparative Efficacy of PD‐1 Inhibitor‐Based Neoadjuvant Chemoimmunotherapy Regimens for Resectable Stage II–IIIa NSCLC: A Real‐World Retrospective Study
Thoracic Cancer
chemoimmunotherapy
immune checkpoint inhibitors
neoadjuvant therapy
non‐small cell lung cancer
surgery
title Comparative Efficacy of PD‐1 Inhibitor‐Based Neoadjuvant Chemoimmunotherapy Regimens for Resectable Stage II–IIIa NSCLC: A Real‐World Retrospective Study
title_full Comparative Efficacy of PD‐1 Inhibitor‐Based Neoadjuvant Chemoimmunotherapy Regimens for Resectable Stage II–IIIa NSCLC: A Real‐World Retrospective Study
title_fullStr Comparative Efficacy of PD‐1 Inhibitor‐Based Neoadjuvant Chemoimmunotherapy Regimens for Resectable Stage II–IIIa NSCLC: A Real‐World Retrospective Study
title_full_unstemmed Comparative Efficacy of PD‐1 Inhibitor‐Based Neoadjuvant Chemoimmunotherapy Regimens for Resectable Stage II–IIIa NSCLC: A Real‐World Retrospective Study
title_short Comparative Efficacy of PD‐1 Inhibitor‐Based Neoadjuvant Chemoimmunotherapy Regimens for Resectable Stage II–IIIa NSCLC: A Real‐World Retrospective Study
title_sort comparative efficacy of pd 1 inhibitor based neoadjuvant chemoimmunotherapy regimens for resectable stage ii iiia nsclc a real world retrospective study
topic chemoimmunotherapy
immune checkpoint inhibitors
neoadjuvant therapy
non‐small cell lung cancer
surgery
url https://doi.org/10.1111/1759-7714.70123
work_keys_str_mv AT boyan comparativeefficacyofpd1inhibitorbasedneoadjuvantchemoimmunotherapyregimensforresectablestageiiiiiansclcarealworldretrospectivestudy
AT xiaoxuansun comparativeefficacyofpd1inhibitorbasedneoadjuvantchemoimmunotherapyregimensforresectablestageiiiiiansclcarealworldretrospectivestudy
AT yansheng comparativeefficacyofpd1inhibitorbasedneoadjuvantchemoimmunotherapyregimensforresectablestageiiiiiansclcarealworldretrospectivestudy
AT ranzhang comparativeefficacyofpd1inhibitorbasedneoadjuvantchemoimmunotherapyregimensforresectablestageiiiiiansclcarealworldretrospectivestudy
AT yanjunsu comparativeefficacyofpd1inhibitorbasedneoadjuvantchemoimmunotherapyregimensforresectablestageiiiiiansclcarealworldretrospectivestudy
AT yulongchen comparativeefficacyofpd1inhibitorbasedneoadjuvantchemoimmunotherapyregimensforresectablestageiiiiiansclcarealworldretrospectivestudy