Overview
Since 2021, several immuno-oncology agents have been approved for use in patients with resectable non-small cell lung cancer (NSCLC), however, in phase III trials 16-26% of patients did not undergo surgery. This study aimed to understand how often real-world patients with stage II or III NSCLC undergo surgery after receiving a combination of immunotherapy and chemotherapy (CT-IO), and treatment patterns and reasons patients did not proceed to surgery.
Researchers looked at patients treated between January 2022 and October 2023. Of the 484 patients who started neoadjuvant CT-IO, about two-thirds (65.5%) went on to have surgery, a rate similar to what has been seen in recent clinical trials. The most common reasons some patients did not have surgery were related to their medical fitness, whether the tumor could be removed, or if the cancer had progressed. Importantly, most patients who did not have surgery received other treatments, such as radiation, during post-neoadjuvant care.
Why this matters
As new immunotherapy options become available for patients with resectable NSCLC, it is important to understand how these treatments are used in everyday clinical practice—not just in clinical trials. Using high-quality real-world data, this study shows that in the real world and especially in community care settings most patients who start neoadjuvant CT-IO are able to proceed to surgery, and the reasons for not having surgery are similar to those seen in trials.