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@ARTICLE{Guberina:306357,
      author       = {M. Guberina$^*$ and M. Metzenmacher$^*$ and C. Pöttgen$^*$
                      and M. Wiesweg$^*$ and N. Guberina$^*$ and A. Merkel-Jens
                      and D. Lütke-Brintrup and S. Bölükbas and W. E. E.
                      Eberhardt$^*$ and G. Stamatis and F. Doerr and T. Plönes
                      and C. Hoffmann$^*$ and G. Zaun$^*$ and B. Höing$^*$ and C.
                      Kürten$^*$ and E. Mladenov and G. Iliakis and D.
                      Kersting$^*$ and W. P. Fendler$^*$ and T. Gauler$^*$ and M.
                      Opitz and A. Milosevic and M. Forsting and F. Nensa and L.
                      Umutlu and F. Funke$^*$ and H. Hautzel$^*$ and K.
                      Herrmann$^*$ and C. Taube and D. Theegarten$^*$ and C.
                      Aigner and M. Schuler$^*$ and M. Stuschke$^*$},
      title        = {{P}athologic {C}omplete {R}esponse {P}redicts {L}ong-{T}erm
                      {S}urvival {F}ollowing {N}eoadjuvant {I}nduction
                      {C}hemotherapy and {C}hemo-{R}adiotherapy in {S}tage-{III}
                      {N}on-{S}mall {C}ell {L}ung {C}ancer.},
      journal      = {Thoracic cancer},
      volume       = {16},
      number       = {22},
      issn         = {1759-7706},
      address      = {Hoboken, NJ ˜[u.a.]œ},
      publisher    = {Wiley-Blackwell},
      reportid     = {DKFZ-2025-02569},
      pages        = {e70183},
      year         = {2025},
      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.},
      keywords     = {Humans / Carcinoma, Non-Small-Cell Lung: pathology /
                      Carcinoma, Non-Small-Cell Lung: mortality / Carcinoma,
                      Non-Small-Cell Lung: therapy / Carcinoma, Non-Small-Cell
                      Lung: drug therapy / Male / Female / Neoadjuvant Therapy:
                      methods / Neoadjuvant Therapy: mortality / Lung Neoplasms:
                      pathology / Lung Neoplasms: mortality / Lung Neoplasms:
                      therapy / Lung Neoplasms: drug therapy / Induction
                      Chemotherapy: methods / Middle Aged / Aged / Neoplasm
                      Staging / Prognosis / Chemoradiotherapy: methods /
                      Pathologic Complete Response / induction
                      chemo‐radiotherapy (Other) / major pathological response
                      (Other) / pathologic complete response (Other) / potentially
                      resectable stage III NSCLC (Other) / predictor of survival
                      (Other)},
      cin          = {ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41261778},
      doi          = {10.1111/1759-7714.70183},
      url          = {https://inrepo02.dkfz.de/record/306357},
}