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An Observational Population Level Study of Neoadjuvant Chemoimmunotherapy for Resectable Non-Small-Cell Lung Cancer
Siddhartha Goutam1, Amanda J W Gibson1, Michelle Liane Dean1
1Department of Oncology, Arthur J.E. Child Comprehensive Cancer Center, Calgary, Alberta, Canada; Glans-Look Lung Cancer Research (GLR) Program, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Clinical Lung Cancer
|July 25, 2026
Summary
Neoadjuvant chemoimmunotherapy (NCIT) for non-small cell lung cancer (NSCLC) shows real-world effectiveness comparable to clinical trials, with high pathological response rates and manageable side effects. Further follow-up is needed to confirm long-term survival benefits.
Area of Science:
- Oncology
- Thoracic Surgery
- Clinical Trials
Background:
- Neoadjuvant chemoimmunotherapy (NCIT) is increasingly adopted for resectable non-small cell lung cancer (NSCLC).
- Real-world data on NCIT effectiveness in routine practice are limited.
- This study evaluates NCIT outcomes in a real-world cohort of NSCLC patients.
Purpose of the Study:
- To assess the real-world pathological response, treatment completion, and surgical outcomes of NCIT in resectable NSCLC.
- To evaluate adverse events and disease recurrence rates following NCIT.
- To compare real-world NCIT effectiveness with findings from pivotal clinical trials.
Main Methods:
- A retrospective analysis of 64 patients with stage II-III NSCLC treated with neoadjuvant Nivolumab and chemotherapy.
- Data collected from a province-wide registry, with a median follow-up of 7 months.
- Primary endpoints included pathological response (pCR, mPR) and treatment completion; secondary endpoints included adverse events and recurrence.
Main Results:
- High treatment completion (89.1%) and surgical resection rates (85.9%) were observed.
- Major pathological response (mPR) was achieved in 44% and complete pathological response (pCR) in 30% of patients.
- Manageable toxicity (71.4% AEs, 15.6% grade ≥3) and favorable surgical outcomes (R0 resection) were noted, with 12.9% experiencing relapse.
Conclusions:
- Real-world NCIT for resectable NSCLC demonstrates pathological response rates comparable to clinical trials.
- The approach shows manageable toxicity and favorable surgical outcomes in routine practice.
- Findings suggest no significant efficacy-effectiveness gap, warranting longer follow-up for survival assessment.
