Cancers (Sep 2021)

Lung Cancer Surgery after Treatment with Anti-PD1/PD-L1 Immunotherapy for Non-Small-Cell Lung Cancer: A Case—Cohort Study

  • Kinan El Husseini,
  • Nicolas Piton,
  • Marielle De Marchi,
  • Antoine Grégoire,
  • Roman Vion,
  • Pierre Blavier,
  • Luc Thiberville,
  • Jean-Marc Baste,
  • Florian Guisier

DOI
https://doi.org/10.3390/cancers13194915
Journal volume & issue
Vol. 13, no. 19
p. 4915

Abstract

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Background: Immune checkpoint inhibitors (ICIs) are the standard of care for non-resectable non-small-cell lung cancer and are under investigation for resectable disease. Some authors have reported difficulties during lung surgery following ICI treatment. This retrospective study investigated the perioperative outcomes of lung resection in patients with preoperative ICI. Methods: Patients with major lung resection after receiving ICIs were included as cases and were compared to patients who received preoperative chemotherapy without ICI. Surgical, clinical, and imaging data were collected. Results: A total of 25 patients were included in the ICI group, and 34 were included in the control group. The ICI patients received five (2–18) infusions of ICI (80% with pembrolizumab). Indications for surgery varied widely across groups (p p = 0.049). Surgery reports showed a higher rate of tissue fibrosis/inflammation in the ICI group (p p = 0.24), with no difference in operating time (p = 0.81) nor more conversions (p = 0.46) or perioperative complications (p = 0.94). There was no 90-day mortality. Disease-free survival was higher in the ICI group (HR = 0.30 (0.13–0.71), p = 0.02). Conclusions: This study further supports the safety and feasibility of lung resection in patients following preoperative treatment with ICI.

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