中国肺癌杂志2025，Vol.28Issue(6)：415-426,12.DOI:10.3779/j.issn.1009-3419.2025.106.16
新辅助免疫治疗联合化疗对ⅠB-ⅢB期非小细胞肺癌患者的疗效和安全性分析
Analysis of Efficacy and Safety of Neoadjuvant Immunochemotherapy in Patients with Stage ⅠB-ⅢB Non-small Cell Lung Cancer
摘要
Abstract
Background and objective Neoadjuvant immunochemotherapy has emerged as an indispensable therapeutic modality for non-small cell lung cancer(NSCLC).However,its clinical application experience remains limited,and the associations between various clinical factors and treatment benefits remain undefined.This study aims to evaluate the efficacy and safety of neoadjuvant immunochemotherapy in patients with stage ⅠB-ⅢB NSCLC in a real-world setting,analyze survival outcomes among subgroups with diverse clinical characteristics,and identify potential clinical predictive factors for pathological response.Methods This study included patients with stage ⅠB-ⅢB NSCLC who underwent radical lung resection after 2-4 cycles of neoadjuvant immunochemotherapy at Peking University People's Hospital between August 2019 and March 2024.Medical records and follow-up information were collected to analyze therapeutic response,adverse events and survival outcomes.Logistic analysis was used to identify clinical predictors of pathological response.Results Among 183 enrolled patients,116(63.4％)were stage Ⅲ.Grade 3-4 immune-related adverse events(irAEs)occurred in 39(21.3％)patients.Ra-diographic complete response(CR)or partial response(PR)was achieved in 118(64.5％)patients.R0 resection was achieved in 180(98.4％)patients.Major pathologic response(MPR)was observed in 107(58.5％)patients,with 78(42.6％)achieving pathologic complete response(pCR).Squamous cell carcinoma and radiographic objective response were associated with pathological response(pCR/MPR).With a median follow-up of 22.1[interquartile range(IQR):18.3-32.2]months,the 2-year event-free survival(EFS)and overall survival(OS)rates were 82.5％and 90.4％,respectively.Achievement of pathological response(pCR/MPR)was correlated with prolonged survival outcomes.Conclusion Neoadjuvant immunochemotherapy is safe and effective for patients with stage ⅠB-ⅢB NSCLC.Patients achieving pCR or MPR exhibit significantly better survival benefits from neoadjuvant immunochemotherapy.Squamous cell carcinoma and radiographic objective response can serve as clinical predictors of pathological response.关键词
肺肿瘤/非小细胞肺癌/新辅助治疗/免疫治疗Key words
Lung neoplasms/Non-small cell lung cancer/Neoadjuvant therapy/Immunotherapy引用本文复制引用
李子豪,王鑫,王玉龙,崔卓尔,王新,李晓,姜冠潮,王迅..新辅助免疫治疗联合化疗对ⅠB-ⅢB期非小细胞肺癌患者的疗效和安全性分析[J].中国肺癌杂志,2025,28(6):415-426,12.基金项目
本研究受国家自然科学基金项目(No.82402144)和北京大学临床医学+X青年专项基金项目(No.PKU2023LCXQ001,No.PKU2024LCXQ043)资助 This study was supported by the grants from National Natural Science Foundation of China(No.82402144),Clinical Medicine Plus X-Young Scholars Project,Peking University,the Fundamental Research Funds for the Central Universities(No.PKU2023LCXQ001,No.PKU2024LCXQ043)(All to Xun WANG). （No.82402144）
