Neoadjuvant immunotherapy combined with chemotherapy for local advanced non-small cell lung cancer: a case report

Immunotherapy has revolutionized lung cancer management and revitalized the field of tumor immunology. Anti-programmed death 1 (anti-PD-1) immunotherapy can significantly improve the survival of patients with advanced non-small cell lung cancer (NSCLC), but its role in neoadjuvant therapy of local advanced NSCLC remains uncertain. Herein, we reported a case from a clinical trial of our department, a patient who achieved excellent outcome after neoadjuvant immunotherapy and chemotherapy for local advanced NSCLC. A 70 years old male patient with stage IIIA squamous cell carcinoma was admitted in our hospital, who initially needed to undergo pneumonectomy. After two cycles of neoadjuvant immunotherapy combined with chemotherapy, the tumor significantly shrank and the patient underwent left upper lobectomy finally. The patient had grade 2 myelosuppression and recovered after injection with recombinant human granulocyte colony stimulating factor. There was no operation-related complication the patient was discharged uneventfully. The patient received two cycles adjuvant chemotherapy combined with immunotherapy, then immunotherapy alone monthly. The patient was well during the 4-month follow-up after surgery and would receive immunotherapy till one year after surgery. Our case added evidence of the feasibility and efficacy of neoadjuvant immunotherapy combined with chemotherapy in local advanced NSCLC. Randomized, controlled, multi-center studies are needed to confirm these findings.