Surgical results of the Lung Cancer Mutation Consortium 3 trial: A phase II multicenter single-arm study to investigate the efficacy and safety of atezolizumab as neoadjuvant therapy in patients with stages IB-select IIIB resectable non-small cell lung cancer.
In: Journal of Thoracic and Cardiovascular Surgery, Jg. 165 (2023-03-01), Heft 3
Online
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OBJECTIVE: Multimodality treatment for resectable non-small cell lung cancer has long remained at a therapeutic plateau. Immune checkpoint inhibitors are highly effective in advanced non-small cell lung cancer and promising preoperatively in small clinical trials for resectable non-small cell lung cancer. This large multicenter trial tested the safety and efficacy of neoadjuvant atezolizumab and surgery. METHODS: Patients with stage IB to select IIIB resectable non-small cell lung cancer and Eastern Cooperative Oncology Group performance status 0/1 were eligible. Patients received atezolizumab 1200 mg intravenously every 3 weeks for 2 cycles or less followed by resection. The primary end point was major pathological response in patients without EGFR/ALK+ alterations. Pre- and post-treatment computed tomography, positron emission tomography, pulmonary function tests, and biospecimens were obtained. Adverse events were recorded by Common Terminology Criteria for Adverse Events v.4.0. RESULTS: From April 2017 to February 2020, 181 patients were entered in the study. Baseline characteristics were mean age, 65.1 years; female, 93 of 181 (51%); nonsquamous histology, 112 of 181 (62%); and clinical stages IIB to IIIB, 147 of 181 (81%). In patients without EGFR/ALK alterations who underwent surgery, the major pathological response rate was 20% (29/143; 95% confidence interval, 14-28) and the pathological complete response rate was 6% (8/143; 95% confidence interval, 2-11). There were no grade 4/5 treatment-related adverse events preoperatively. Of 159 patients (87.8%) undergoing surgery, 145 (91%) had pathologic complete resection. There were 5 (3%) intraoperative complications, no intraoperative deaths, and 2 postoperative deaths within 90 days, 1 treatment related. Median disease-free and overall survival have not been reached. CONCLUSIONS: Neoadjuvant atezolizumab in resectable stage IB to IIIB non-small cell lung cancer was well tolerated, yielded a 20% major pathological response rate, and allowed safe, complete surgical resection. These results strongly support the further development of immune checkpoint inhibitors as preoperative therapy in locally advanced non-small cell lung cancer.
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Surgical results of the Lung Cancer Mutation Consortium 3 trial: A phase II multicenter single-arm study to investigate the efficacy and safety of atezolizumab as neoadjuvant therapy in patients with stages IB-select IIIB resectable non-small cell lung cancer.
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Autor/in / Beteiligte Person: | Rusch, Valerie ; Nicholas, Alan ; Patterson, G ; Waqar, Salama ; Toloza, Eric ; Haura, Eric ; Raz, Dan ; Reckamp, Karen ; Merritt, Robert ; Owen, Dwight ; Finley, David ; McNamee, Ciaran ; Blasberg, Justin ; Garon, Edward ; Mitchell, John ; Doebele, Robert ; Baciewicz, Frank ; Pass, Harvey ; Schulze, Katja ; Johnson, Ann ; Bunn, Paul ; Johnson, Bruce ; Kris, Mark ; Kwiatkowski, David ; Wistuba, Ignacio ; Chaft, Jamie ; Carbone, David ; Lee, Jay ; Nagasaka, Misako |
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Zeitschrift: | Journal of Thoracic and Cardiovascular Surgery, Jg. 165 (2023-03-01), Heft 3 |
Veröffentlichung: | eScholarship, University of California, 2023 |
Medientyp: | academicJournal |
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