Is adjuvant immunotherapy necessary after neoadjuvant chemoimmunotherapy in patients with resectable stage III NSCLC? A two-center real-world study
Abstract Purpose The value of adjuvant immunotherapy in patients with resectable stage III non-small cell lung cancer (NSCLC) after neoadjuvant chemoimmunotherapy remains unclear. This study aimed to evaluate the prognostic impact of additional adjuvant immunotherapy in patients with stage III NSCLC...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Springer
2025-07-01
|
| Series: | Cancer Immunology, Immunotherapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s00262-025-04130-z |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849234961228365824 |
|---|---|
| author | Song Guan Hui Wang Zhaoxin Chen Fengrui Guo Guozhen Yi Xingyu Du Jingjing Yan Cuimeng Tian |
| author_facet | Song Guan Hui Wang Zhaoxin Chen Fengrui Guo Guozhen Yi Xingyu Du Jingjing Yan Cuimeng Tian |
| author_sort | Song Guan |
| collection | DOAJ |
| description | Abstract Purpose The value of adjuvant immunotherapy in patients with resectable stage III non-small cell lung cancer (NSCLC) after neoadjuvant chemoimmunotherapy remains unclear. This study aimed to evaluate the prognostic impact of additional adjuvant immunotherapy in patients with stage III NSCLC. Methods Patients with stage III NSCLC who received neoadjuvant chemoimmunotherapy followed by radical surgery, with or without adjuvant immunotherapy, were retrospectively enrolled across two hospitals. Event-free survival (EFS) and overall survival (OS) were assessed from the initiation of neoadjuvant treatment and were estimated by the Kaplan‒Meier method. One-to-one propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to minimize confounding. Results A total of 184 eligible patients were enrolled, of whom 105 (57.1%) received adjuvant immunotherapy and 79 (42.9%) did not. After 1:1 PSM, the addition of adjuvant immunotherapy did not significantly improve EFS (2-year EFS: 62.3% vs. 66.1%, P = 0.653) or OS (2-year OS: 92.7% vs. 89.6%, P = 0.196). Subgroup analyses, stratified by the pathological complete response (pCR) status, further confirmed that adjuvant immunotherapy did not significantly improve survival in either the pCR subgroup or the non-pCR subgroup. Similar results were obtained after IPTW. Exploratory analysis revealed that 3 cycles of neoadjuvant immunotherapy might be more beneficial than 2 (pCR: 40.8% vs. 30.6%, P = 0.292; 2-year EFS: 75.0% vs. 54.5%, P = 0.111) or 4 (pCR: 42.1% vs. 36.8%, P = 0.740; 2-year EFS: 63.2% vs. 51.5%, P = 0.343) cycles. Conclusion The addition of adjuvant immunotherapy to neoadjuvant chemoimmunotherapy may not be necessary in patients with resectable stage III NSCLC. Three cycles of neoadjuvant immunotherapy appear to be an appropriate treatment regimen for neoadjuvant chemoimmunotherapy. |
| format | Article |
| id | doaj-art-f30e737b838f4562a75b0de964dcf3d7 |
| institution | Kabale University |
| issn | 1432-0851 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Springer |
| record_format | Article |
| series | Cancer Immunology, Immunotherapy |
| spelling | doaj-art-f30e737b838f4562a75b0de964dcf3d72025-08-20T04:02:57ZengSpringerCancer Immunology, Immunotherapy1432-08512025-07-0174811210.1007/s00262-025-04130-zIs adjuvant immunotherapy necessary after neoadjuvant chemoimmunotherapy in patients with resectable stage III NSCLC? A two-center real-world studySong Guan0Hui Wang1Zhaoxin Chen2Fengrui Guo3Guozhen Yi4Xingyu Du5Jingjing Yan6Cuimeng Tian7Department of Radiation Oncology, Beijing Chest Hospital, Capital Medical University & Beijing Tuberculosis and Thoracic Tumor Research InstituteDepartment of Respiratory and Critical Care, Hebei Petrochina Central HospitalDepartment of Medical Oncology, Beijing Chest Hospital, Capital Medical University & Beijing Tuberculosis and Thoracic Tumor Research InstituteDepartment of Respiratory and Critical Care, Hebei Petrochina Central HospitalDepartment of Respiratory and Critical Care, Hebei Petrochina Central HospitalDepartment of Radiation Oncology, Beijing Chest Hospital, Capital Medical University & Beijing Tuberculosis and Thoracic Tumor Research InstituteDepartment of Respiratory and Critical Care, Hebei Petrochina Central HospitalDepartment of Radiation Oncology, Beijing Chest Hospital, Capital Medical University & Beijing Tuberculosis and Thoracic Tumor Research InstituteAbstract Purpose The value of adjuvant immunotherapy in patients with resectable stage III non-small cell lung cancer (NSCLC) after neoadjuvant chemoimmunotherapy remains unclear. This study aimed to evaluate the prognostic impact of additional adjuvant immunotherapy in patients with stage III NSCLC. Methods Patients with stage III NSCLC who received neoadjuvant chemoimmunotherapy followed by radical surgery, with or without adjuvant immunotherapy, were retrospectively enrolled across two hospitals. Event-free survival (EFS) and overall survival (OS) were assessed from the initiation of neoadjuvant treatment and were estimated by the Kaplan‒Meier method. One-to-one propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to minimize confounding. Results A total of 184 eligible patients were enrolled, of whom 105 (57.1%) received adjuvant immunotherapy and 79 (42.9%) did not. After 1:1 PSM, the addition of adjuvant immunotherapy did not significantly improve EFS (2-year EFS: 62.3% vs. 66.1%, P = 0.653) or OS (2-year OS: 92.7% vs. 89.6%, P = 0.196). Subgroup analyses, stratified by the pathological complete response (pCR) status, further confirmed that adjuvant immunotherapy did not significantly improve survival in either the pCR subgroup or the non-pCR subgroup. Similar results were obtained after IPTW. Exploratory analysis revealed that 3 cycles of neoadjuvant immunotherapy might be more beneficial than 2 (pCR: 40.8% vs. 30.6%, P = 0.292; 2-year EFS: 75.0% vs. 54.5%, P = 0.111) or 4 (pCR: 42.1% vs. 36.8%, P = 0.740; 2-year EFS: 63.2% vs. 51.5%, P = 0.343) cycles. Conclusion The addition of adjuvant immunotherapy to neoadjuvant chemoimmunotherapy may not be necessary in patients with resectable stage III NSCLC. Three cycles of neoadjuvant immunotherapy appear to be an appropriate treatment regimen for neoadjuvant chemoimmunotherapy.https://doi.org/10.1007/s00262-025-04130-zAdjuvant immunotherapyNeoadjuvant chemoimmunotherapyNon-small cell lung cancerSurgery |
| spellingShingle | Song Guan Hui Wang Zhaoxin Chen Fengrui Guo Guozhen Yi Xingyu Du Jingjing Yan Cuimeng Tian Is adjuvant immunotherapy necessary after neoadjuvant chemoimmunotherapy in patients with resectable stage III NSCLC? A two-center real-world study Cancer Immunology, Immunotherapy Adjuvant immunotherapy Neoadjuvant chemoimmunotherapy Non-small cell lung cancer Surgery |
| title | Is adjuvant immunotherapy necessary after neoadjuvant chemoimmunotherapy in patients with resectable stage III NSCLC? A two-center real-world study |
| title_full | Is adjuvant immunotherapy necessary after neoadjuvant chemoimmunotherapy in patients with resectable stage III NSCLC? A two-center real-world study |
| title_fullStr | Is adjuvant immunotherapy necessary after neoadjuvant chemoimmunotherapy in patients with resectable stage III NSCLC? A two-center real-world study |
| title_full_unstemmed | Is adjuvant immunotherapy necessary after neoadjuvant chemoimmunotherapy in patients with resectable stage III NSCLC? A two-center real-world study |
| title_short | Is adjuvant immunotherapy necessary after neoadjuvant chemoimmunotherapy in patients with resectable stage III NSCLC? A two-center real-world study |
| title_sort | is adjuvant immunotherapy necessary after neoadjuvant chemoimmunotherapy in patients with resectable stage iii nsclc a two center real world study |
| topic | Adjuvant immunotherapy Neoadjuvant chemoimmunotherapy Non-small cell lung cancer Surgery |
| url | https://doi.org/10.1007/s00262-025-04130-z |
| work_keys_str_mv | AT songguan isadjuvantimmunotherapynecessaryafterneoadjuvantchemoimmunotherapyinpatientswithresectablestageiiinsclcatwocenterrealworldstudy AT huiwang isadjuvantimmunotherapynecessaryafterneoadjuvantchemoimmunotherapyinpatientswithresectablestageiiinsclcatwocenterrealworldstudy AT zhaoxinchen isadjuvantimmunotherapynecessaryafterneoadjuvantchemoimmunotherapyinpatientswithresectablestageiiinsclcatwocenterrealworldstudy AT fengruiguo isadjuvantimmunotherapynecessaryafterneoadjuvantchemoimmunotherapyinpatientswithresectablestageiiinsclcatwocenterrealworldstudy AT guozhenyi isadjuvantimmunotherapynecessaryafterneoadjuvantchemoimmunotherapyinpatientswithresectablestageiiinsclcatwocenterrealworldstudy AT xingyudu isadjuvantimmunotherapynecessaryafterneoadjuvantchemoimmunotherapyinpatientswithresectablestageiiinsclcatwocenterrealworldstudy AT jingjingyan isadjuvantimmunotherapynecessaryafterneoadjuvantchemoimmunotherapyinpatientswithresectablestageiiinsclcatwocenterrealworldstudy AT cuimengtian isadjuvantimmunotherapynecessaryafterneoadjuvantchemoimmunotherapyinpatientswithresectablestageiiinsclcatwocenterrealworldstudy |