Perioperative Toripalimab Plus Chemotherapy for Patients With Resectable Non-Small Cell Lung Cancer: The Neotorch...

Area of Science:

• Oncology
• Immunotherapy
• Thoracic Surgery

Background:

• Adjuvant and neoadjuvant immunotherapy have shown promise in improving outcomes for early-stage non-small cell lung cancer (NSCLC).
• The optimal combination of checkpoint inhibitors with chemotherapy for resectable NSCLC is still under investigation.

Purpose of the Study:

• To evaluate the efficacy of toripalimab plus platinum-based chemotherapy versus chemotherapy alone in improving event-free survival and major pathological response.
• To assess the safety and tolerability of this combination therapy in patients with resectable stage II or III NSCLC.

Main Methods:

• A randomized clinical trial involving patients with resectable stage II or III NSCLC (excluding EGFR/ALK alterations for nonsquamous histology).
• Patients received either toripalimab or placebo every 3 weeks, combined with platinum-based chemotherapy for 3 cycles pre-surgery and 1 cycle post-surgery, followed by maintenance therapy.
• Primary outcomes included event-free survival and major pathological response rate; secondary outcomes included pathological complete response and adverse events.

Main Results:

• The toripalimab group showed significantly improved event-free survival (median not estimable vs. 15.1 months) and a higher major pathological response rate (48.5% vs. 8.4%) compared to placebo.
• Pathological complete response was also significantly higher in the toripalimab group (24.8% vs. 1.0%).
• Immune-related adverse events were more frequent with toripalimab, but overall grade 3+ adverse events, fatal events, and treatment discontinuations were comparable between groups.

Conclusions:

• Perioperative toripalimab combined with chemotherapy significantly enhances event-free survival in patients with resectable stage III NSCLC.
• This combination therapy presents a manageable safety profile, offering a promising treatment strategy for resectable NSCLC.