Summary of studies investigating neoadjuvant immunotherapy in resectable lung cancer

StudyAuthor, yearStudy phaseStudy protocolStudy populationNumber of patientsMPR (%)pCR (%)DFS/EFS/OS (%)
Trials investigating neoadjuvant immunotherapy + chemotherapy
NeoSTAR NCT03158129Cascone et al. [14], 2023IIArm 1: Nivolumab (x3)
Arm 2: Nivolumab + Ipilimumab (x1)
Arm 3: Nivolumab (x3) + CT
Arm 4: Nivolumab (x3) + Ipilimumab (x1) + CT
Resectable IA-IIIA NSCLCArm 1: 23
Arm 2: 21
Arm 3: 22
Arm 4: 22
22
38
32.1
50
9
29
18.2
18.2
12 m EFS: 96% (Arm 3) vs. 82% (Arm 4)
CheckMate-816 NCT02998528Spicer et al. [13], 2023IIIArm 1: Nivolumab + Platinum CT
Arm 2: Platinum CT
Resectable IB-IIIA NSCLCArm 1: 179
Arm 2: 179
36.9
8.9
24
2.2
31.6 m (95% CI, 30.2-NR) vs. 20.8 m (95% CI, 14.0 to 26.7) HR 0.63; P = 0.005).
24 m EFS: 63.8% vs. 45.3%
OS improvement of 13% in Nivolumab + CT group
No NCT IDNShen et al. [15], 2021IPembrolizumab 2 mg/kg + Nab-paclitaxel + Carboplatin (x2)Resectable stage IIB–IIIB squamous lung3745.964.9-
NCT04304248Zhao et al. [40], 2021 IIToripalimab + Carboplatin + Pemetrexed/Nab-paclitaxel (x3)Resectable stage IIIA or T3-4N2 IIIB NSCLC3360.645.5-
Lung-Mate001 ChiCTR1900023758Zhang et al. [37], 2021IISintilimab + Carboplatin + Pemetrexed/Gemcitabine) (x2-4)Resectable stage IB–IIIA5043.320-
Neo-Pre-IC NCT04326153Sun et al. [41], 2024 IISintilimab + Nab-paclitaxel + Carboplatin (x2-3)Resectable IIIA/IIIB NSCLC30654024 m DFS: 75%
No NCTDuan et al. [42], 2021ICT + ImmunotherapyStage IIA–IIIB NSCLC235030-
NCT02716038Shu et al. [43], 2020IIAtezolizumab + Carboplatin/Nab-paclitaxel (x2-4)Resectable IB-IIIA NSCLC305733-
NCT03480230Tfayli et al. [16], 2020IAvelumab (x4) + Cisplatin/Carboplatin + Gemcitabine/Pemetrexed (x3)Stage IB–IIIA NSCLC152211-
Trials investigating neoadjuvant immunotherapy
ChiCTR-OIC-17013726Gao et al. [44], 2020 IBSintilimab 200 mg (x2)Resectable stage IA–IIIB NSCLC4040.516.2-
CheckMate-159 NCT02259621Forde et al. [17], 2018; Reuss et al. [18], 2020IB/IIArm 1: Nivolumab (x2)
Arm 2: Nivolumab (x3) + Ipilimumab (x1)
Resectable IB-IIIA NSCLCArm 1: 21
Arm 2: 9
45
33.3
10
33.3
-
NEOMUN NCT03197467Eichhorn et al. [45], 2021IIPembrolizumab (x2)Resectable stage II–IIIA1527--
IONESCO NCT03030131Wislez et al. [20], 2022IIDurvalumab (x3)IB-IIIA (non-N2) resectable NSCLC4619312 m OS—89% (95% CI 75.8% to 95.3%)
12 m DFS—78% (95% CI 63.4% to 87.7%)
NeoCOAST NCT03794544Cascone et al. [19], 2023IIArm 1: Durvalumab
Arm 2: Durvalumab + Oleclumab
Arm 3: Durvalumab + Monalizumab
Arm 4: Durvalumab + Danvatirsen
Stage IA–IIIA NSCLCArm 1: 27
Arm 2: 21
Arm 3: 20
Arm 4: 16
12.5
22.2
33.3
33.3
3.7
9.5
10
12.5
-
NCT02927301Rusch et al. [46], 2023IIAtezolizumab (x2)Resectable stage IB–IIIB (non-EGFR/ALK)143206-
Trials investigating perioperative immunotherapy +/- chemotherapy
NADIM NCT03081689Provencio et al. [47], 2020IIPaclitaxel + Carboplatin + Nivolumab (x3) > Sx > NivolumabResectable stage IIIA NSCLC46836324 m PFS 77.1%
NADIM II NCT03838159Provencio et al. [25], 2022IIArm 1: Nivolumab + Platinum CT (x3) > Sx > Nivolumab (x6)
Arm 2: Platinum CT
Resectable stage IIIA–IIIB NSCLCArm 1: 57
Arm 2: 29
53
14
37
7
24 m OS 85% vs. 63.6% (HR 0.43)
24 m PFS 67.2% vs. 40.9% (HR 0.47)
TOP 1501 NCT02818920Tong et al. [48], 2022IIPembrolizumab (x2) > Sx > Pembrolizumab (x4)Stage IB–IIIA NSCLC3028--
KEYNOTE-671 NCT034256643Wakelee et al. [24], 2023IIIArm 1: Pembrolizumab + Platinum CT (x4) > Sx > Pembrolizumab (x13)
Arm 2: Placebo + Platinum CT (x4) > Sx > Placebo (x13)
Resectable stage II–IIIB NSCLC79730.2
11
18.1
4
24 m EFS—62.4% vs. 40.6% (HR 0.58)
24 m OS: 80.9% vs. 77.6% (P = 0.02)
NEOTORCH4 NCT04158440Lu et al. [49], 2024IIIArm 1: Toripalimab + Platinum CT (x3) > Sx > Toripalimab (x13)
Arm 2: Placebo + Platinum CT (x3) > Sx > Placebo (x13)
Resectable stage II–III NSCLCArm 1: 202
Arm 2: 202
48.5
8.4
24.8
1
mEFS: NE (95% CI, 24.4m–NE) vs. 15.1 m (95% CI, 10.6 m–21.9 m) (HR 0.40)
SAKK 16/14 NCT02572843Rothschild et al. [22], 2021IIDocetaxel + Cisplatin (x3) + Durvalumab (x2); > Sx > Durvalumab (x26)T1-3N2 stage IIIA NSCLC67621812 m EFS—73%
12 m OS—91%
AEGEAN NCT03800134Heymach et al. [23], 2023IIICT + Durvalumab or placebo (x3) > Sx > Durvalumab or placebo (x12)Resectable Stage II–IIIBArm 1: 366
Arm 2: 374
33.3
12.3
17.2
4.3
EFS NR (31.9 m–NR) vs. 25.9 m (18.9 m–NR), HR 0.68
NCT04316364Yan et al. [50], 2023IBAdebrelimab, Nab-paclitaxel + Carboplatin (x3) > Sx > Adebrelimab (x16)Resectable stage II–III NSCLC3751.429.7-
Trials investigating neoadjuvant IO with radiotherapy
NCT02904954Altorki et al. [51], 2021IIDurvalumab alone vs. Durvalumab + Stereotactic RTResectable stage I–IIIAArm 1: 30
Arm 2: 30
6.7
53.3
26-
NCT03030131 (IONESCO)Wislez et al. [20], 2022IIDurvalumab alone vs. Durvalumab + Stereotactic RTStage I–IIIAArm 1: 26
Arm 2: 26
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m: month; NSCLC: non-small cell lung cancer; CT: chemotherapy; EFS: event free survival; NR: not reached; CI: confidence interval; NCT: National Clinical Trial; IDN: identification number; DFS: disease free survival; PFS: progression free survival; HR: hazard ratio; Sx: surgery; MPR: major pathological response; pCR: pathological complete response; OS: overall survival; EGFR: epidermal growth factor receptor; ALK: anaplastic lymphoma kina