neoSCI：可切除小细胞肺癌的新辅助或者转化免疫治疗

neoSCI：可切除小细胞肺癌的新辅助或者转化免疫治疗

A multicenter, single-arm, open study of neoadjuvant or conversion atezolizumab in combination with chemotherapy in resectable small cell lung cancer (neoSCI) (Cohort Study)

Background: This study aimed to investigate the prospects of using chemotherapy in combination with atezolizumab in the neoadjuvant or conversion treatment of small cell lung cancer (SCLC).

Methods: Prior to surgery, untreated patients with limited-stage SCLC received 3 cycles of neoadjuvant or conversion atezolizumab combined with chemotherapy of etoposide and platinum. The primary endpoint of the trial was pathological complete response (pCR) in the per-protocol (PP) cohort. In addition, safety was assessed based on treatment-related adverse events (AEs) and postoperative complications.

Results: Overall, thirteen of seventeen patients (including fourteen males and three females) underwent surgery. In the PP cohort, pCR and MPR were observed in eight (8/13, 61.5%) and twelve (12/13, 92.3%) patients, respectively. According to the intention-to-treat (ITT) analysis, the pCR and major pathological response (MPR) in the ITT cohort were 47.1% (8/17) and 70.6% (12/17), respectively. In addition, an ORR of 100% was recorded in the PP cohort. Moreover, fifteen (15/17, 88.2%) patients and one (1/17, 5.9%) in the ITT cohort attained partial remission (PR), and complete remission (CR), respecstively, with an overall response rate (ORR) of 94.1%. The median OS of the patients of pCR and the median EFS of the patients on surgery had not achieved. However, the median OS of the patients of non-pCR was 18.2 months and the median EFS of the non-surgical patients was 9.5 months. During the neoadjuvant treatment, the incidence of grade 3 or higher AEs was 58.8% (10/17). Additionally, three patients (17.6%) developed immune-related adverse event (irAE, grade 1-2).

Conclusion: In patients with SCLC, neoadjuvant or conversion atezolizumab combined with chemotherapy significantly improved pCR with manageable AEs. Therefore, this regimen may be considered a safe and effective treatment for SCLC.

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Duan H, Shi L, Shao C, Wang Y, Wang Z, Ni Y, Zhao J, Sun J, Tong L, Lei J, Jiang T, Liu Z, Yan X. A multicenter, single-arm, open study of neoadjuvant or conversion atezolizumab in combination with chemotherapy in resectable small cell lung cancer (neoSCI) (Cohort Study). Int J Surg. 2023 Jul 10;109(9):2641–9. doi: 10.1097/JS9.0000000000000501. Epub ahead of print. PMID: 37428211; PMCID: PMC10498862.