Immunotherapy (excluding checkpoint inhibitors) for stage I to III non-small cell lung cancer treated with surgery or radiotherapy with curative intent

Zhu, Jianwei; Yuan, Charlotte; Wang, Xiaoyu; Yin, Daqiang; Li, Rui; Chen, Wenwen; Suo, Chen; Song, Huan

doi:10.1002/14651858.cd011300.pub3

Cited by 13 publications

(8 citation statements)

References 59 publications

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“…Since the introduction of immunotherapy, the area of therapeutic approaches for NSCLC has taken on a whole new perspective and demonstrated considerable promise. Jianwei Zhu presented a review (6) of immunotherapy, which found that immunotherapies other than immune checkpoint inhibitor therapy, the current literature does not provide evidence that suggests a survival benefit from adding immunotherapy (excluding checkpoint inhibitors) to conventional curative surgery or radiotherapy, for people with localized NSCLC (stages I to III). However, patients with metastatic NSCLC who receive treatment with checkpoint inhibitors that target programmed cell death protein 1 (PD-1) and programmed death ligand-1 (PD-L1) have shown improved disease response rates and longer lifetime (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

The benefit and risk of PD-1/PD-L1 inhibitors plus anti-angiogenic agents as second or later-line treatment for patients with advanced non-small-cell lung cancer: a systematic review and single-arm meta-analysis of prospective clinical trials

Chen

Jiang

et al. 2023

Front. Immunol.

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BackgroundPrevious studies revealed that Programmed cell death protein 1 (PD-1)/Programmed cell death-Ligand protein 1 (PD-L1) inhibitors plus anti-angiogenic agents had extensive anti-tumor activities. However, almost all studies on the efficacy and safety of PD-1/PD-L1 inhibitors plus anti-angiogenic agents as second or later-line treatment for patients with advanced non-small cell lung cancer are non-randomized controlled trials with small sample sizes, which might lead to a lack of effective metrics to assess the effectiveness and safety of the therapeutic regimen. Here, this meta-analysis aimed to evaluate the efficacy and safety of PD-1/PD-L1 inhibitors plus anti-angiogenic agents as second or later-line treatment for patients with advanced non-small cell lung cancerMethodsA single-arm meta-analysis was performed, and published literature from PubMed, Web of Science and Embase databases as of January 13, 2023, was systematically retrieved. We used the Cochrane risk of bias tool and methodological index for non-randomized studies (MINORS) Methodological items to evaluate the quality of eligible clinical trials. Outcomes including overall response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and adverse events (AEs) were extracted for further analysis. The random effect model is used to calculate the pooled parameters.Results19 studies (16 were non-comparative single-arm clinical trials and 3 were randomized controlled trials) were enrolled in this meta-analysis. In terms of tumor response, the pooled ORR and DCR were 22.4% (95% CI, 16.6-28.1%) and 76.8% (95% CI, 72.6-81.1%), respectively. With regard to survival analysis, the pooled PFS and OS were 5.20 (95% CI, 4.46-5.93) months and 14.09 (95% CI, 13.20-14.97) months, respectively. The pooled grade ≥3 adverse effect (AE) rate was 47.6% (95% CI, 33.1-62.0%)ConclusionPD-1/PD-L1 inhibitors plus anti-angiogenic agents has promising efficacy and safety as second or later-line treatment in patients with advanced non-small cell lung cancer.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023407559.

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Section: Introductionmentioning

confidence: 99%

The benefit and risk of PD-1/PD-L1 inhibitors plus anti-angiogenic agents as second or later-line treatment for patients with advanced non-small-cell lung cancer: a systematic review and single-arm meta-analysis of prospective clinical trials

Chen

Jiang

et al. 2023

Front. Immunol.

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“…Currently, the treatment modalities for stage I NSCLC include surgery, radiotherapy, chemotherapy, laser ablation, cryosurgery, electrocautery, fulguration and combined treatments. Moreover, studies have shown that for patients with localized NSCLC (stages I to III), the addition of immunotherapy to conventional curative surgery or radiation therapy provides a survival advantage [ 6 ]. Therefore, the multiple treatment choices need to be systematically evaluated and compared to determine the most effective treatment modality.…”

Section: Introductionmentioning

confidence: 99%

Treatment strategies for stage IA non-small cell lung cancer: A SEER-based population study

Wu,

Zhang,

Feng

et al. 2024

PLoS ONE

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Background There are various therapeutic methods for treating stage IA (T1N0M0) non-small cell lung cancer (NSCLC), but no studies have systematically assessed multiple treatments to determine the most effective therapy. Methods Stage IA NSCLC patient data collected between 2004 and 2018 were gathered from the Surveillance, Epidemiology, and End Results (SEER) database. Treatment modalities included observation, chemotherapy alone (CA), radiation alone (RA), radiation+chemotherapy (RC), surgery alone (SA), surgery+chemotherapy (SC), surgery+radiation (SR) and surgery+radiation+chemotherapy (SRC). Comparisons were made of overall survival (OS) and lung cancer-specific survival (LCSS) among patients based on different therapeutic methods by survival analysis. Results Ultimately, 89147 patients with stage IA NSCLC between 2004 and 2018 were enrolled in this study. The order of multiple treatment modalities based on the hazard ratio (HR) for OS for the entire cohort revealed the following results: SA (HR: 0.20), SC (HR: 0.25), SR (HR: 0.42), SRC (HR: 0.46), RA (HR: 0.56), RC (HR: 0.72), CA (HR: 0.91) (P<0.001), and observation (HR: Ref). The SA group had the best OS and LCSS, and similar results were found in most subgroup analyses (all P<0.001). The order of surgical modalities based on the HR for OS for the entire cohort revealed the following results: lobectomy (HR: 0.32), segmentectomy (HR: 0.41), wedge resection (HR: 0.52) and local tumor destruction (HR: Ref). Lobectomy had the best effects on OS and LCSS, and similar results were found in all subgroup analyses (all P<0.001). Conclusion SA appeared to be the optimal treatment modality for patients with stage IA NSCLC, and lobectomy was associated with the best prognosis. There may be some indication and selection bias in our study, and the results of this study should be confirmed in a prospective study.

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“…Epidemiologically, the incidence of PSC ranges from approximately 0.1% to 0.4% in NSCLC 3 . Surgical resection is currently the preferred treatment, but guidelines for adjuvant chemotherapy have not yet been established, especially for the advanced stage 4 . However, the benefit of adjuvant chemotherapy in surgically treated PSC patients in this rare cancer remains controversial.…”

Section: Introductionmentioning

confidence: 99%

“…3 Surgical resection is currently the preferred treatment, but guidelines for adjuvant chemotherapy have not yet been established, especially for the advanced stage. 4 However, the benefit of adjuvant chemotherapy in surgically treated PSC patients in this rare cancer remains controversial. Additionally, immuno-targeted therapy may be important in the management of PSC.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive treatment for ROS1‐overexpressed pulmonary sarcomatoid carcinoma: A case report

Sun

Wang

Shi

et al. 2023

Clinical Case Reports

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Key Clinical Message In conclusion author highlights the tumor cell genetic testing or molecular pathological diagnosis plays a key role in the individualized treatment of PSC, which could benefit patients with advanced PSC. Abstract An uncommon form of non‐small‐cell lung cancer (NSCLC) with a poor prognosis is pulmonary sarcomatoid carcinoma (PSC). Surgical resection is currently the preferred treatment, but guidelines for adjuvant chemotherapy have not yet been established, especially for the advanced stage. The development of molecular subgroups in the field of tumors may be advantageous to advanced PSC patients with the ongoing progress of genomics and immunology. A 54‐year‐old man presented to Xishan People's Hospital of Wuxi City with recurrent intermittent dry cough with fever for 1 month. Further examinations suggested the diagnosis of PSC occupying almost the entire right interlobar fissure area combined with malignant pleural effusion (Stage IVa). Pathological examination confirmed the diagnosis of PSC with ROS1 overexpressing via genetic testing. However, after three cycles of chemo‐, antiangiogenetic‐ and immunochemical therapy, the lesion was localized, and pleural effusion disappeared, the patient subsequently received an operation which was performed as R0 resection. Unfortunately, the patient became deteriorated quickly followed by extensive metastatic nodules in the thoracic cavity. Although the patient continued to receive chemo‐ and immunochemical‐therapy, it did not limit the progress of the tumor, leading to widespread metastasis, and eventually died of multiple organ failure. For PSC patients with Stage IVa, chemo‐, antiangiogenetic‐ and immunochemical‐therapy performs well in clinical efficacy, and comprehensive panel‐based genetic testing may offer PSC patients a somewhat better prognosis. However, blindly implementing surgical treatment may bring harm to the patient and affect long‐term survival. It's essential to know the surgical indications precisely by NSCLC guidelines.

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Immunotherapy (excluding checkpoint inhibitors) for stage I to III non-small cell lung cancer treated with surgery or radiotherapy with curative intent

Cited by 13 publications

References 59 publications

The benefit and risk of PD-1/PD-L1 inhibitors plus anti-angiogenic agents as second or later-line treatment for patients with advanced non-small-cell lung cancer: a systematic review and single-arm meta-analysis of prospective clinical trials

The benefit and risk of PD-1/PD-L1 inhibitors plus anti-angiogenic agents as second or later-line treatment for patients with advanced non-small-cell lung cancer: a systematic review and single-arm meta-analysis of prospective clinical trials

Treatment strategies for stage IA non-small cell lung cancer: A SEER-based population study

Comprehensive treatment for ROS1‐overexpressed pulmonary sarcomatoid carcinoma: A case report

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