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. > print

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024 7 _ |a 10.1111/1759-7714.70183
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037 _ _ |a DKFZ-2025-02569
041 _ _ |a English
082 _ _ |a 610
100 1 _ |a Guberina, Maja
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245 _ _ |a Pathologic Complete Response Predicts Long-Term Survival Following Neoadjuvant Induction Chemotherapy and Chemo-Radiotherapy in Stage-III Non-Small Cell Lung Cancer.
260 _ _ |a Hoboken, NJ ˜[u.a.]œ
|c 2025
|b Wiley-Blackwell
336 7 _ |a article
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520 _ _ |a 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.
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650 _ 7 |a induction chemo‐radiotherapy
|2 Other
650 _ 7 |a major pathological response
|2 Other
650 _ 7 |a pathologic complete response
|2 Other
650 _ 7 |a potentially resectable stage III NSCLC
|2 Other
650 _ 7 |a predictor of survival
|2 Other
650 _ 2 |a Humans
|2 MeSH
650 _ 2 |a Carcinoma, Non-Small-Cell Lung: pathology
|2 MeSH
650 _ 2 |a Carcinoma, Non-Small-Cell Lung: mortality
|2 MeSH
650 _ 2 |a Carcinoma, Non-Small-Cell Lung: therapy
|2 MeSH
650 _ 2 |a Carcinoma, Non-Small-Cell Lung: drug therapy
|2 MeSH
650 _ 2 |a Male
|2 MeSH
650 _ 2 |a Female
|2 MeSH
650 _ 2 |a Neoadjuvant Therapy: methods
|2 MeSH
650 _ 2 |a Neoadjuvant Therapy: mortality
|2 MeSH
650 _ 2 |a Lung Neoplasms: pathology
|2 MeSH
650 _ 2 |a Lung Neoplasms: mortality
|2 MeSH
650 _ 2 |a Lung Neoplasms: therapy
|2 MeSH
650 _ 2 |a Lung Neoplasms: drug therapy
|2 MeSH
650 _ 2 |a Induction Chemotherapy: methods
|2 MeSH
650 _ 2 |a Middle Aged
|2 MeSH
650 _ 2 |a Aged
|2 MeSH
650 _ 2 |a Neoplasm Staging
|2 MeSH
650 _ 2 |a Prognosis
|2 MeSH
650 _ 2 |a Chemoradiotherapy: methods
|2 MeSH
650 _ 2 |a Pathologic Complete Response
|2 MeSH
700 1 _ |a Metzenmacher, Martin
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700 1 _ |a Pöttgen, Christoph
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700 1 _ |a Wiesweg, Marcel
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700 1 _ |a Guberina, Nika
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700 1 _ |a Merkel-Jens, Anja
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700 1 _ |a Lütke-Brintrup, Diana
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700 1 _ |a Bölükbas, Servet
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700 1 _ |a Eberhardt, Wilfried E E
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700 1 _ |a Stamatis, Georgios
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700 1 _ |a Doerr, Fabian
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700 1 _ |a Plönes, Till
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700 1 _ |a Hoffmann, Christian
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700 1 _ |a Zaun, Gregor
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700 1 _ |a Höing, Benedikt
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700 1 _ |a Kürten, Cornelius
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700 1 _ |a Mladenov, Emil
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700 1 _ |a Iliakis, George
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700 1 _ |a Kersting, David
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700 1 _ |a Fendler, Wolfgang P
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700 1 _ |a Gauler, Thomas
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700 1 _ |a Opitz, Marcel
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700 1 _ |a Milosevic, Aleksandar
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700 1 _ |a Forsting, Michael
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700 1 _ |a Nensa, Felix
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700 1 _ |a Umutlu, Lale
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700 1 _ |a Funke, Faustina
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700 1 _ |a Hautzel, Hubertus
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700 1 _ |a Herrmann, Ken
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700 1 _ |a Taube, Christian
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700 1 _ |a Theegarten, Dirk
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700 1 _ |a Aigner, Clemens
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700 1 _ |a Schuler, Martin
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700 1 _ |a Stuschke, Martin
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