guest ::
| Home > Publications database > Pathologic Complete Response Predicts Long-Term Survival Following Neoadjuvant Induction Chemotherapy and Chemo-Radiotherapy in Stage-III Non-Small Cell Lung Cancer. |
| Home > Publications database > Pathologic Complete Response Predicts Long-Term Survival Following Neoadjuvant Induction Chemotherapy and Chemo-Radiotherapy in Stage-III Non-Small Cell Lung Cancer. |
| Journal Article | DKFZ-2025-02569 |
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ;
2025
Wiley-Blackwell
Hoboken, NJ [u.a.]
Abstract: To analyze the association of pathologic-complete-response (PCR) and survival after neoadjuvant concurrent chemo-radiotherapy, we evaluated a large cohort of patients with potentially resectable stage IIIA-IIIC non-small cell lung cancer (NSCLC) treated with a trimodality approach.Consecutive patients underwent neoadjuvant induction chemotherapy, followed by concurrent chemo-radiotherapy and surgery. Patients received established imaging, and diagnostics. Leave-one-out cross-validation was employed to identify the most effective prognostic classifier.Altogether, 403 patients treated between 06/2000 and 01/2020 were included. Median follow-up was 111 months (IQR: 71-127 months). PCR was achieved in 34% (137 patients) after neoadjuvant therapy and major-pathologic response without PCR in 30% (MPR> 0%-≤ 10% defined as viable cells in > 0% and ≤ 10% of the sample). PCR was significantly dependent on histology (p = 0.0005) and radiotherapy fractionation schedule (p = 0.027). PCR rates were higher for squamous than for non-squamous carcinoma with 46.2% (95% CI: 37.8%-54.7%) versus 27.3% (95% CI: 22.0%-33.2%). PCR was the most significant prognostic factor for long-term survival with an associated hazard ratio of 0.272 (0.192-0.386), while MPR was associated with a hazard ratio of 0.671 (0.498-0.905) in comparison to lesser response. Overall survival at 5/10 years with PCR was 72.9% (95% CI: 64.4%-79.6%)/ 62.8% (53.0%-71.1%)/ event-free survival at 5 years 69.5% (60.9%-76.7%). Identified through cross-validation, key prognostic features included PCR, MPR, and treatment period following 18F-FDG-PET/CT-guided staging.Induction chemotherapy followed by chemo-radiotherapy results in high PCR rates. In this investigation, PCR is followed by high event-free and overall survival rates. These data warrant further investigation of chemo-radiotherapy as a significant component of neoadjuvant treatment regimens in trials combined with immunotherapy. This strategy may increase the PCR rates, particularly for patients with more advanced, potentially resectable stage III NSCLC.
Keyword(s): Humans (MeSH) ; Carcinoma, Non-Small-Cell Lung: pathology (MeSH) ; Carcinoma, Non-Small-Cell Lung: mortality (MeSH) ; Carcinoma, Non-Small-Cell Lung: therapy (MeSH) ; Carcinoma, Non-Small-Cell Lung: drug therapy (MeSH) ; Male (MeSH) ; Female (MeSH) ; Neoadjuvant Therapy: methods (MeSH) ; Neoadjuvant Therapy: mortality (MeSH) ; Lung Neoplasms: pathology (MeSH) ; Lung Neoplasms: mortality (MeSH) ; Lung Neoplasms: therapy (MeSH) ; Lung Neoplasms: drug therapy (MeSH) ; Induction Chemotherapy: methods (MeSH) ; Middle Aged (MeSH) ; Aged (MeSH) ; Neoplasm Staging (MeSH) ; Prognosis (MeSH) ; Chemoradiotherapy: methods (MeSH) ; Pathologic Complete Response (MeSH) ; induction chemo‐radiotherapy ; major pathological response ; pathologic complete response ; potentially resectable stage III NSCLC ; predictor of survival
; 
; Article Processing Charges ; Clarivate Analytics Master Journal List ; DEAL Wiley ; DOAJ Seal ; Ebsco Academic Search ; Essential Science Indicators ; Fees ; IF < 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection
|
The record appears in these collections: |
