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2000
Volume 20, Issue 4
  • ISSN: 1574-8928
  • E-ISSN: 2212-3970

Abstract

Objective

This study aimed to explore the clinical efficacy and safety of durvalumab combined with albumin-bound paclitaxel and carboplatin as neoadjuvant therapy for resectable stage III Non-small Cell Lung Cancer (NSCLC).

Methods

A single-arm open-label phase Ib study was conducted. A total of 40 patients with driver gene-negative resectable stage III NSCLC were enrolled. All patients received neoadjuvant treatment with durvalumab in combination with albumin-bound paclitaxel and carboplatin. The clinical efficacy, Major Pathological Response (MPR), Complete Pathological Response (pCR), and safety were assessed. Flow cytometry was used to detect the expression of programmed cell death receptor 1 (PD-1) on total T, helper T, and cytotoxic T lymphocytes in peripheral blood before and after neoadjuvant treatment. Adverse reactions during the treatment were recorded. Disease-free Survival (DFS) and Overall Survival (OS) curves were constructed.

Results

After the neoadjuvant treatment, the overall Objective Response Rate (ORR) in the 40 patients with NSCLC was 65.00%. MPR was achieved in 27 patients (67.50%), and pCR was achieved in nine patients (22.50%). The expression levels of PD-1 on total T, helper T, and cytotoxic T lymphocytes in patients with NSCLC significantly decreased after treatment (all < 0.05). The most common adverse events were hair loss (47.50%), nausea and vomiting (42.50%), and fatigue (40.00%). The majority of adverse events were grades 1 and 2, with a small number of events being grades 3 and 4. At the end of the follow-up period, the average DFS was 21.49 ± 0.99 months, and the average OS was 24.79 ± 0.53 months.

Conclusion

Neoadjuvant treatment with durvalumab combined with albumin-bound paclitaxel and carboplatin as first-line therapy for driver gene-negative stage III NSCLC achieved a high pathological response rate and improved immune function. It is expected to extend patient survival with good tolerability.

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2025-05-06
2025-12-22
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References

  1. SungH. FerlayJ. SiegelR.L. LaversanneM. SoerjomataramI. JemalA. BrayF. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.CA Cancer J. Clin.202171320924910.3322/caac.2166033538338
    [Google Scholar]
  2. ShankarA. SainiD. DubeyA. RoyS. BharatiS.J. SinghN. KhannaM. PrasadC.P. SinghM. KumarS. SirohiB. SethT. RinkiM. MohanA. GuleriaR. RathG.K. Feasibility of lung cancer screening in developing countries: Challenges, opportunities and way forward.Transl. Lung Cancer Res.20198S1S106S12110.21037/tlcr.2019.03.0331211111
    [Google Scholar]
  3. EttingerD.S. WoodD.E. AisnerD.L. AkerleyW. BaumanJ.R. BharatA. BrunoD.S. ChangJ.Y. ChirieacL.R. D’AmicoT.A. DeCampM. DillingT.J. DowellJ. GettingerS. GrotzT.E. GubensM.A. HegdeA. LacknerR.P. LanutiM. LinJ. LooB.W. LovlyC.M. MaldonadoF. MassarelliE. MorgenszternD. NgT. OttersonG.A. PachecoJ.M. PatelS.P. RielyG.J. RiessJ. SchildS.E. ShapiroT.A. SinghA.P. StevensonJ. TamA. TanvetyanonT. YanagawaJ. YangS.C. YauE. GregoryK. HughesM. Non–small cell lung cancer, version 3.2022, NCCN clinical practice guidelines in oncology.J. Natl. Compr. Canc. Netw.202220549753010.6004/jnccn.2022.002535545176
    [Google Scholar]
  4. ChenP. LiuY. WenY. ZhouC. Non-small cell lung cancer in China.Cancer Commun.2022421093797010.1002/cac2.1235936075878
    [Google Scholar]
  5. Abu RousF. SinghiE.K. SridharA. FaisalM.S. DesaiA. Lung cancer treatment advances in 2022.Cancer Invest.2023411122410.1080/07357907.2022.211947936036470
    [Google Scholar]
  6. AlexanderM. KimS.Y. ChengH. Update 2020: Management of non-small cell lung cancer.Lung2020198689790710.1007/s00408‑020‑00407‑533175991
    [Google Scholar]
  7. DumaN. Santana-DavilaR. MolinaJ.R. Non–small cell lung cancer: Epidemiology, screening, diagnosis, and treatment.Mayo Clin. Proc.20199481623164010.1016/j.mayocp.2019.01.01331378236
    [Google Scholar]
  8. LeeJ.M. McNameeC.J. TolozaE. NegraoM.V. LinJ. ShumE. CummingsA.L. KrisM.G. SepesiB. BaraI. KurtsikidzeN. SchulzeK. NgiamC. ChaftJ.E. Neoadjuvant targeted therapy in resectable NSCLC: Current and future perspectives.J. Thorac. Oncol.202318111458147710.1016/j.jtho.2023.07.00637451404
    [Google Scholar]
  9. JaziehA.R. ZeitouniM. AlghamdiM. AlrujaibM. LotfiS. Abu DaffS. AlomairA. AlshehriS. AlhusainiH. AllehebiA. AnsariJ. AlnassarM. JafarH. AlfarsiA. AbdelhafeezN. AlkattanK. Management guidelines for stage III non-small cell lung cancer.Crit. Rev. Oncol. Hematol.202115710314410.1016/j.critrevonc.2020.10314433254035
    [Google Scholar]
  10. DoroshowD.B. SanmamedM.F. HastingsK. PolitiK. RimmD.L. ChenL. MeleroI. SchalperK.A. HerbstR.S. Immunotherapy in non–small cell lung cancer: Facts and hopes.Clin. Cancer Res.201925154592460210.1158/1078‑0432.CCR‑18‑153830824587
    [Google Scholar]
  11. ChenY. GaoM. HuangZ. YuJ. MengX. SBRT combined with PD-1/PD-L1 inhibitors in NSCLC treatment: A focus on the mechanisms, advances, and future challenges.J. Hematol. Oncol.202013110510.1186/s13045‑020‑00940‑z32723363
    [Google Scholar]
  12. GengY. ZhangQ. FengS. LiC. WangL. ZhaoX. YangZ. LiZ. LuoH. LiuR. LuB. WangX. Safety and efficacy of PD-1/PD-L1 inhibitors combined with radiotherapy in patients with non-small-cell lung cancer: A systematic review and meta-analysis.Cancer Med.20211041222123910.1002/cam4.371833465302
    [Google Scholar]
  13. RothschildS.I. ZippeliusA. EbouletE.I. PrinceS.S. BetticherD. BettiniA. FrühM. JoergerM. LardinoisD. GelpkeH. MautiL.A. BritschgiC. WederW. PetersS. MarkM. CathomasR. OchsenbeinA.F. JanthurW.D. WaibelC. MachN. FroeschP. BuessM. BohanesP. GodarG. RusterholzC. GonzalezM. PlessM. SAKK 16/14: Durvalumab in addition to neoadjuvant chemotherapy in patients with stage IIIA(N2) non–small-cell lung cancer—A multicenter single-arm phase II trial.J. Clin. Oncol.202139262872288010.1200/JCO.21.0027634251873
    [Google Scholar]
  14. ShuC.A. GainorJ.F. AwadM.M. ChiuzanC. GriggC.M. PabaniA. GarofanoR.F. StooplerM.B. ChengS.K. WhiteA. LanutiM. D’OvidioF. BacchettaM. SonettJ.R. SaqiA. RizviN.A. Neoadjuvant atezolizumab and chemotherapy in patients with resectable non-small-cell lung cancer: An open-label, multicentre, single-arm, phase 2 trial.Lancet Oncol.202021678679510.1016/S1470‑2045(20)30140‑632386568
    [Google Scholar]
  15. GirardN. BarJ. GarridoP. GarassinoM.C. McDonaldF. MornexF. FilippiA.R. SmitH.J.M. PetersS. FieldJ.K. ChristophD.C. SibilleA. FietkauR. HaakensenV.D. ChouaidC. MarkmanB. HiltermannT.J.N. TausA. SawyerW. AllenA. ChanderP. LicourM. SolomonB. Treatment characteristics and real-world progression-free survival in patients with unresectable stage III NSCLC who received durvalumab after chemoradiotherapy: Findings from the PACIFIC-R study.J. Thorac. Oncol.202318218119310.1016/j.jtho.2022.10.00336307040
    [Google Scholar]
  16. AntoniaS.J. VillegasA. DanielD. VicenteD. MurakamiS. HuiR. KurataT. ChiapporiA. LeeK.H. de WitM. ChoB.C. BourhabaM. QuantinX. TokitoT. MekhailT. PlanchardD. KimY.C. KarapetisC.S. HiretS. OstorosG. KubotaK. GrayJ.E. Paz-AresL. de CarpeñoC.J. FinnF.C. ReckM. VansteenkisteJ. SpigelD.R. WadsworthC. MelilloG. TaboadaM. DennisP.A. ÖzgüroğluM. Overall survival with durvalumab after chemoradiotherapy in stage III NSCLC.N. Engl. J. Med.2018379242342235010.1056/NEJMoa180969730280658
    [Google Scholar]
  17. ArgoteA.J. DasanuC.A. Durvalumab in cancer medicine: A comprehensive review.Expert Opin. Biol. Ther.201919992793510.1080/14712598.2019.163511531272242
    [Google Scholar]
  18. MiyanagaA. AsahinaH. WatanabeS. ShukuyaT. TsubataY. HosomiY. SugawaraS. MaemondoM. OkanoT. MoritaS. MatsuyamaK. KobayashiK. SeikeM. A phase I/II study of necitumumab plus pembrolizumab, nab-paclitaxel, and carboplatin for previously untreated advanced squamous non–small cell lung cancer study: (NEJ048A/NEXUS).Clin. Lung Cancer202324437137510.1016/j.cllc.2023.01.00836849264
    [Google Scholar]
  19. ChaiY. WuX. ZouY. ZhangX. BaiH. DongM. DuanJ. Immunotherapy combined with chemotherapy versus chemotherapy alone as the first-line treatment of PD-L1-negative and driver-gene-negative advanced nonsquamous non-small-cell lung cancer: An updated systematic review and meta-analysis.Thorac. Cancer202213223124313210.1111/1759‑7714.1466436168110
    [Google Scholar]
  20. EisenhauerE.A. TherasseP. BogaertsJ. SchwartzL.H. SargentD. FordR. DanceyJ. ArbuckS. GwytherS. MooneyM. RubinsteinL. ShankarL. DoddL. KaplanR. LacombeD. VerweijJ. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1).Eur. J. Cancer200945222824710.1016/j.ejca.2008.10.02619097774
    [Google Scholar]
  21. HellmannM.D. ChaftJ.E. WilliamW.N.Jr RuschV. PistersK.M.W. KalhorN. PataerA. TravisW.D. SwisherS.G. KrisM.G. Pathological response after neoadjuvant chemotherapy in resectable non-small-cell lung cancers: Proposal for the use of major pathological response as a surrogate endpoint.Lancet Oncol.2014151e42e5010.1016/S1470‑2045(13)70334‑624384493
    [Google Scholar]
  22. TravisW.D. DacicS. WistubaI. ShollL. AdusumilliP. BubendorfL. BunnP. CasconeT. ChaftJ. ChenG. ChouT.Y. CooperW. ErasmusJ.J. FerreiraC.G. GooJ.M. HeymachJ. HirschF.R. HorinouchiH. KerrK. KrisM. JainD. KimY.T. Lopez-RiosF. LuS. MitsudomiT. MoreiraA. MotoiN. NicholsonA.G. OliveiraR. PapottiM. PastorinoU. Paz-AresL. PelosiG. PoleriC. ProvencioM. RodenA.C. ScagliottiG. SwisherS.G. ThunnissenE. TsaoM.S. VansteenkisteJ. WederW. YatabeY. IASLC multidisciplinary recommendations for pathologic assessment of lung cancer resection specimens after neoadjuvant therapy.J. Thorac. Oncol.202015570974010.1016/j.jtho.2020.01.00532004713
    [Google Scholar]
  23. OstorosG. HettleR. GeorgouliaN. BerktasM. ChanderP. PerezD.I. CoutoA.M. EichingerC. FieldP. MortenP. Association between event-free survival and overall survival after neoadjuvant treatment for non-small cell lung cancer: A systematic review and meta-analysis.Expert Rev. Anticancer Ther.202323121305131310.1080/14737140.2023.227264537850939
    [Google Scholar]
  24. KimY.H. Durvalumab after chemoradiotherapy in stage III non–small-cell lung cancer.N. Engl. J. Med.20193801098999010.1056/NEJMc190040730855760
    [Google Scholar]
  25. MatsudaA. YamaokaK. KunitohH. SetoT. TsuboiM. OhiraT. MaruyamaR. OkamotoH. KubotaK. Quality of life with docetaxel plus cisplatin versus paclitaxel plus carboplatin in patients with completely resected non-small cell lung cancer: quality of life analysis of TORG 0503.Qual. Life Res.20233292629263710.1007/s11136‑023‑03424‑y37126140
    [Google Scholar]
  26. WangH. MouS. TuM. Study on the effect of nano albumin paclitaxel combined with carboplatin in the treatment of lung squamous cell carcinoma.J. Nanosci. Nanotechnol.202020127439744310.1166/jnn.2020.1888032711612
    [Google Scholar]
  27. GanJ. HuangY. FangW. ZhangL. Research progress in immune checkpoint inhibitors for lung cancer in China.Ther. Adv. Med. Oncol.2021131758835921102982610.1177/1758835921102982634349843
    [Google Scholar]
  28. WangJ. LiJ. CaiL. ChenS. JiangY. The safety and efficacy of neoadjuvant programmed death 1 inhibitor therapy with surgical resection in stage IIIA non-small cell lung cancer.Ann. Transl. Med.20219648610.21037/atm‑21‑67033850883
    [Google Scholar]
  29. PatelS.A. GibsonM.K. DealA. ShethS. HeilingH. JohnsonS.M. DouglasK. FloresM. BlumbergJ. LumleyC. YarbroughW.G. ShenC. CheraB.S. BaumanJ.R. HackmanT. WeissJ. A phase 2 study of neoadjuvant chemotherapy plus durvalumab in resectable locally advanced head and neck squamous cell carcinoma.Cancer2023129213381338910.1002/cncr.3493037395170
    [Google Scholar]
  30. ProvencioM. NadalE. InsaA. CampeloG.M.R. RubioC.J. DómineM. MajemM. AbreuR.D. MartíM.A. De CarpeñoC.J. CoboM. VivancoL.G. BarcoD.E. CaroB.R. ViñolasN. ArandaB.I. ViteriS. PereiraE. RoyuelaA. CasarrubiosM. AntónS.C. ParraE.R. WistubaI. CalvoV. BriviescaL.R. RomeroA. MassutiB. BermúdezC.A. Neoadjuvant chemotherapy and nivolumab in resectable non-small-cell lung cancer (NADIM): An open-label, multicentre, single-arm, phase 2 trial.Lancet Oncol.202021111413142210.1016/S1470‑2045(20)30453‑832979984
    [Google Scholar]
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