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CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg 2023; 71(03): 222-230
DOI: 10.1055/s-0042-1758552
Original Thoracic

The Safety and Efficacy of Preoperative Immunotherapy Combined with Chemotherapy in Patients with Stage IIIA-IIIB Lung Squamous Cell Carcinoma

Ying Wang‡   *
1   Operating Room Nursing Department, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
,
Cheng He‡   *
2   Department of Thoracic Surgery, Zhejiang University School of Medicine, the First Affiliated Hospital, Hangzhou, China
,
Jiacong Liu‡   *
2   Department of Thoracic Surgery, Zhejiang University School of Medicine, the First Affiliated Hospital, Hangzhou, China
,
Simeng Wu‡   *
3   Department of Cardiothoracic Surgery, the Shaoxing Second Hospital, Shaoxing, China
,
Xuhua Huang
2   Department of Thoracic Surgery, Zhejiang University School of Medicine, the First Affiliated Hospital, Hangzhou, China
,
Lichen Zhang
2   Department of Thoracic Surgery, Zhejiang University School of Medicine, the First Affiliated Hospital, Hangzhou, China
,
Wenbo Shu
2   Department of Thoracic Surgery, Zhejiang University School of Medicine, the First Affiliated Hospital, Hangzhou, China
,
Chen Gu
2   Department of Thoracic Surgery, Zhejiang University School of Medicine, the First Affiliated Hospital, Hangzhou, China
,
Yiqing Wang
2   Department of Thoracic Surgery, Zhejiang University School of Medicine, the First Affiliated Hospital, Hangzhou, China
,
Linhai Zhu 
2   Department of Thoracic Surgery, Zhejiang University School of Medicine, the First Affiliated Hospital, Hangzhou, China
,
Jian Hu
2   Department of Thoracic Surgery, Zhejiang University School of Medicine, the First Affiliated Hospital, Hangzhou, China
› Author Affiliations Funding This research was supported by the Zhejiang Province Major Science and Technology Special Program Project (grant number 2020C03058), the Zhejiang Province Lung Tumor Diagnosis and Treatment Technology Research Supported by the Center (grant number JBZX-202007), the Zhejiang Provincial Traditional Chinese Medicine (Integrated Traditional Chinese and Western Medicine) Key Discipline (grant number 2017-XK-A33) and the Zhejiang Provincial Natural Science Foundation (grant number LY19H160039).
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Abstract

Objective Data on preoperative immunotherapy combined with chemotherapy in potentially resectable lung squamous cell carcinoma (LUSC) remain scarce. This study was designed to investigate the safety and efficacy of preoperative immunotherapy and chemotherapy for stage IIIA-IIIB LUSC.

Methods This study consecutively enrolled stage IIIA-IIIB LUSC who received preoperative immunotherapy combined with chemotherapy between January 2019 and July 2021. Patients received two to four cycles of immunotherapy combined with platinum-based doublet chemotherapy (platinum + paclitaxel) before surgery. Patients were assessed radiographically every one to two cycles until surgery. Postoperative pathological evaluation was also performed. Follow-up was performed until at least 3 months after surgery.

Results Sixty-five patients with stage IIIA-IIIB LUSC were enrolled. The objective response rate was 78.46% (51/65), and no patients had progressive disease. Fifty-seven patients underwent surgery, and 55 patients achieved R0 resection. There were no perioperative deaths. The rate of pathological complete response (pCR) was 31.58% (18/57) and major pathological response was 68.42% (39/57). The incidence of grade 3 and 4 adverse reactions was 21.21 and 1.54%, respectively.

Conclusion Perioperative immunotherapy combined with chemotherapy followed by surgical resection for male patients with stage IIIA-IIIB LUSC was effective with a tolerable toxicity profile.

Keywords

lung squamous cell carcinoma - preoperative treatment - immunotherapy - chemotherapy - surgery

Authors' Contribution

Y.W. and C.H. contributed toward conceptualization, data curation, formal analysis, software, visualization, and writing – original draft. J.L. and S.W. contributed toward conceptualization, methodology, investigation, data curation, visualization, writing – original draft. S.W. contributed toward conceptualization, methodology, investigation, data curation, visualization, and writing – original draft. X.H. did the investigation and data curation. L.Z., W.S., and C.G. did the data curation and visualization. Y.W. worked on methodology and visualization. L.Z. and J.H. did the conceptualization, data curation, funding acquisition, project administration, resources, supervision, validation, writing – review and editing. All authors contributed to the article and approved the submitted version.


* YW, CH, JL, SW contributed equally.




Publication History

Received: 01 August 2022

Accepted: 25 September 2022

Article published online:
29 November 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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