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Perioperative Immunotherapy in Non–Small-Cell Lung Cancer

Two studies examine the use of perioperative immunotherapy in patients with early-stage and stage 3 non–small-cell lung cancer (NSCLC) with pembrolizumab and nivolumab, respectively.

“Among patients with resectable, early-stage NSCLC, neoadjuvant pembrolizumab plus chemotherapy followed by resection and adjuvant pembrolizumab significantly improved event-free survival, major pathological response, and pathological complete response as compared with neoadjuvant chemotherapy alone followed by surgery,” KEYNOTE-671 investigators conclude based on outcomes in 797 participants. “Overall survival did not differ significantly between the groups in this analysis.”

Neoadjuvant nivolumab was studied with platinum-based chemotherapy in an open-label, phase 2 trial of 86 patients with resectable stage IIIA or IIIB NSCLC. “Perioperative treatment with nivolumab plus chemotherapy resulted in a higher percentage of patients with a pathological complete response and longer survival than chemotherapy alone,” the NADIM II investigators conclude.

Editorial: “The energy in the field of early-stage lung cancer is palpable,” an editorialist writes. “This energy needs to be matched with equivalent efforts toward advancing lung cancer screening; in the United States, for example, screening rates remain at approximately 5%. Furthermore, parallel efforts need to be made to implement these cutting-edge treatments broadly and equitably to prevent widening the gaps that already exist for lung cancer and ensure that all patients have access to potentially life-saving therapies. Although questions and challenges remain, this trial and others are unlocking the KEY to improved outcomes for patients with early-stage lung cancer.”

Source: New England Journal of Medicine