Opinion
Video
Evolving NSCLC Landscape: Comparing Recent Updates in Neoadjuvant and Perioperative Immunotherapy
An expert comparison of recent data on neoadjuvant and perioperative immunotherapy in resectable early-stage NSCLC, including CheckMate 77T, CheckMate-816, and KEYNOTE-671.
This is a video synopsis/summary of a Post Conference Perspectives involving Patrick Forde, MBBCh.
Forde notes there is no direct comparison yet between perioperative trials using neoadjuvant immunotherapy plus adjuvant therapy vs neoadjuvant therapy alone. However, cross-trial comparisons suggest comparable 2-year event-free survival rates around 60% to 65% between the shorter 3-cycle neoadjuvant regimen in CheckMate-816 (NCT02998528) and longer regimens in KEYNOTE-671 (NCT03425643) and CheckMate-77T (NCT04025879). Among patients without a pathologic complete response (pCR), there is a suggestion of better outcomes with adjuvant therapy, but it is not definitive yet. An update from CheckMate-816 found very high 3-year overall survival exceeding 95% in patients achieving a pCR, despite most having stage III disease, for which historically, outcomes were much worse.
Forde explains that historically, positive adjuvant chemotherapy trials led to a focus on postoperative therapy over the past 15 years. However, with immunotherapy, there may be greater benefit from neoadjuvant treatment with immune checkpoint inhibitors to stimulate the immune system while tumor is still present. Data from melanoma also support crucial benefit from the neoadjuvant setting. Consequently, there has been a shift toward neoadjuvant chemoimmunotherapy. This requires close collaboration between specialties and early tumor testing to ensure patients with targetable mutations receive appropriate therapy.
Video synopsis is AI-generated and reviewed by AJMC® editorial staff.
