New territories: perioperative chemoimmunotherapy in early-stage NSCLC

Mené en Chine sur 453 patients atteints d'un cancer du poumon non à petites cellules résécable (âge médian : 62 ans ; durée médiane de suivi : 22 mois), cet essai de phase III évalue l'efficacité, du point de vue du taux de réponse et de la survie sans événement, et la toxicité de l'ajout du tislélizumab à une chimiothérapie néoadjuvante

Résumé en anglais

Immune checkpoint inhibitors have recently been used for curative-intent treatment in early-stage non-small-cell lung cancer (NSCLC) in addition to metastatic-stage NSCLC. After two decades in which platinum doublet chemotherapy1 was the only choice for postoperative treatment, the breakthrough of using programmed cell death-1 (PD-1) and programmed cell death ligand-1 (PD-L1) checkpoint inhibitors has substantially impacted survival outcomes. However, debate remains about whether long-term PD-1 or PD-L1 inhibitor treatment with or without chemotherapy will provide greater efficacy in preoperative (neoadjuvant),2 postoperative (adjuvant),3,4 or perioperative (neoadjuvant and adjuvant)5–7 treatment or whether a shorter treatment duration provides the same therapeutic effect and a better quality of life. These diverse options have compelled oncologists to make complex decisions. For instance, an exploratory analysis comparing CheckMate 77T and CheckMate 816 concluded that perioperative treatment is superior to postoperative treatment.8 However, attention should be paid when interpreting results of these treatments, because target populations have different potentials for resection in the early stages of NSCLC.