Summary of studies investigating neoadjuvant immunotherapy in resectable lung cancer
Study | Author, year | Study phase | Study protocol | Study population | Number of patients | MPR (%) | pCR (%) | DFS/EFS/OS (%) |
---|---|---|---|---|---|---|---|---|
Trials investigating neoadjuvant immunotherapy + chemotherapy | ||||||||
NeoSTAR NCT03158129 | Cascone et al. [14], 2023 | II | Arm 1: Nivolumab (x3)Arm 2: Nivolumab + Ipilimumab (x1)Arm 3: Nivolumab (x3) + CTArm 4: Nivolumab (x3) + Ipilimumab (x1) + CT | Resectable IA-IIIA NSCLC | Arm 1: 23Arm 2: 21Arm 3: 22Arm 4: 22 | 223832.150 | 92918.218.2 | 12 m EFS: 96% (Arm 3) vs. 82% (Arm 4) |
CheckMate-816 NCT02998528 | Spicer et al. [13], 2023 | III | Arm 1: Nivolumab + Platinum CTArm 2: Platinum CT | Resectable IB-IIIA NSCLC | Arm 1: 179Arm 2: 179 | 36.98.9 | 242.2 | 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 IDN | Shen et al. [15], 2021 | I | Pembrolizumab 2 mg/kg + Nab-paclitaxel + Carboplatin (x2) | Resectable stage IIB–IIIB squamous lung | 37 | 45.9 | 64.9 | - |
NCT04304248 | Zhao et al. [40], 2021 | II | Toripalimab + Carboplatin + Pemetrexed/Nab-paclitaxel (x3) | Resectable stage IIIA or T3-4N2 IIIB NSCLC | 33 | 60.6 | 45.5 | - |
Lung-Mate001 ChiCTR1900023758 | Zhang et al. [37], 2021 | II | Sintilimab + Carboplatin + Pemetrexed/Gemcitabine) (x2-4) | Resectable stage IB–IIIA | 50 | 43.3 | 20 | - |
Neo-Pre-IC NCT04326153 | Sun et al. [41], 2024 | II | Sintilimab + Nab-paclitaxel + Carboplatin (x2-3) | Resectable IIIA/IIIB NSCLC | 30 | 65 | 40 | 24 m DFS: 75% |
No NCT | Duan et al. [42], 2021 | I | CT + Immunotherapy | Stage IIA–IIIB NSCLC | 23 | 50 | 30 | - |
NCT02716038 | Shu et al. [43], 2020 | II | Atezolizumab + Carboplatin/Nab-paclitaxel (x2-4) | Resectable IB-IIIA NSCLC | 30 | 57 | 33 | - |
NCT03480230 | Tfayli et al. [16], 2020 | I | Avelumab (x4) + Cisplatin/Carboplatin + Gemcitabine/Pemetrexed (x3) | Stage IB–IIIA NSCLC | 15 | 22 | 11 | - |
Trials investigating neoadjuvant immunotherapy | ||||||||
ChiCTR-OIC-17013726 | Gao et al. [44], 2020 | IB | Sintilimab 200 mg (x2) | Resectable stage IA–IIIB NSCLC | 40 | 40.5 | 16.2 | - |
CheckMate-159 NCT02259621 | Forde et al. [17], 2018; Reuss et al. [18], 2020 | IB/II | Arm 1: Nivolumab (x2)Arm 2: Nivolumab (x3) + Ipilimumab (x1) | Resectable IB-IIIA NSCLC | Arm 1: 21Arm 2: 9 | 4533.3 | 1033.3 | - |
NEOMUN NCT03197467 | Eichhorn et al. [45], 2021 | II | Pembrolizumab (x2) | Resectable stage II–IIIA | 15 | 27 | - | - |
IONESCO NCT03030131 | Wislez et al. [20], 2022 | II | Durvalumab (x3) | IB-IIIA (non-N2) resectable NSCLC | 46 | 19 | 3 | 12 m OS—89% (95% CI 75.8% to 95.3%)12 m DFS—78% (95% CI 63.4% to 87.7%) |
NeoCOAST NCT03794544 | Cascone et al. [19], 2023 | II | Arm 1: DurvalumabArm 2: Durvalumab + OleclumabArm 3: Durvalumab + MonalizumabArm 4: Durvalumab + Danvatirsen | Stage IA–IIIA NSCLC | Arm 1: 27Arm 2: 21Arm 3: 20Arm 4: 16 | 12.522.233.333.3 | 3.79.51012.5 | - |
NCT02927301 | Rusch et al. [46], 2023 | II | Atezolizumab (x2) | Resectable stage IB–IIIB (non-EGFR/ALK) | 143 | 20 | 6 | - |
Trials investigating perioperative immunotherapy +/- chemotherapy | ||||||||
NADIM NCT03081689 | Provencio et al. [47], 2020 | II | Paclitaxel + Carboplatin + Nivolumab (x3) > Sx > Nivolumab | Resectable stage IIIA NSCLC | 46 | 83 | 63 | 24 m PFS 77.1% |
NADIM II NCT03838159 | Provencio et al. [25], 2022 | II | Arm 1: Nivolumab + Platinum CT (x3) > Sx > Nivolumab (x6)Arm 2: Platinum CT | Resectable stage IIIA–IIIB NSCLC | Arm 1: 57Arm 2: 29 | 5314 | 377 | 24 m OS 85% vs. 63.6% (HR 0.43)24 m PFS 67.2% vs. 40.9% (HR 0.47) |
TOP 1501 NCT02818920 | Tong et al. [48], 2022 | II | Pembrolizumab (x2) > Sx > Pembrolizumab (x4) | Stage IB–IIIA NSCLC | 30 | 28 | - | - |
KEYNOTE-671 NCT034256643 | Wakelee et al. [24], 2023 | III | Arm 1: Pembrolizumab + Platinum CT (x4) > Sx > Pembrolizumab (x13)Arm 2: Placebo + Platinum CT (x4) > Sx > Placebo (x13) | Resectable stage II–IIIB NSCLC | 797 | 30.211 | 18.14 | 24 m EFS—62.4% vs. 40.6% (HR 0.58)24 m OS: 80.9% vs. 77.6% (P = 0.02) |
NEOTORCH4 NCT04158440 | Lu et al. [49], 2024 | III | Arm 1: Toripalimab + Platinum CT (x3) > Sx > Toripalimab (x13)Arm 2: Placebo + Platinum CT (x3) > Sx > Placebo (x13) | Resectable stage II–III NSCLC | Arm 1: 202Arm 2: 202 | 48.58.4 | 24.81 | 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 NCT02572843 | Rothschild et al. [22], 2021 | II | Docetaxel + Cisplatin (x3) + Durvalumab (x2); > Sx > Durvalumab (x26) | T1-3N2 stage IIIA NSCLC | 67 | 62 | 18 | 12 m EFS—73%12 m OS—91% |
AEGEAN NCT03800134 | Heymach et al. [23], 2023 | III | CT + Durvalumab or placebo (x3) > Sx > Durvalumab or placebo (x12) | Resectable Stage II–IIIB | Arm 1: 366Arm 2: 374 | 33.312.3 | 17.24.3 | EFS NR (31.9 m–NR) vs. 25.9 m (18.9 m–NR), HR 0.68 |
NCT04316364 | Yan et al. [50], 2023 | IB | Adebrelimab, Nab-paclitaxel + Carboplatin (x3) > Sx > Adebrelimab (x16) | Resectable stage II–III NSCLC | 37 | 51.4 | 29.7 | - |
Trials investigating neoadjuvant IO with radiotherapy | ||||||||
NCT02904954 | Altorki et al. [51], 2021 | II | Durvalumab alone vs. Durvalumab + Stereotactic RT | Resectable stage I–IIIA | Arm 1: 30Arm 2: 30 | 6.753.3 | 26 | - |
NCT03030131 (IONESCO) | Wislez et al. [20], 2022 | II | Durvalumab alone vs. Durvalumab + Stereotactic RT | Stage I–IIIA | Arm 1: 26Arm 2: 26 | - | - | - |
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