Novel neoadjuvant chemoimmunotherapy treatments are being investigated for locally advanced non–small-cell lung cancer (NSCLC), but real-world outcomes for neoadjuvant treatments are poorly understood. This study examined neoadjuvant treatment patterns, real-world event-free survival (rwEFS) and overall survival (OS) in patients with resected, stage II-III NSCLC in the United States (US). This retrospective study identified patients in the SEER–Medicare database (2007-2019) with newly diagnosed stage II, IIIA, and IIIB (N2) NSCLC (AJCC 8th edition) treated with neoadjuvant chemo/chemoradiotherapy and resection (index date: neoadjuvant therapy initiation). Neoadjuvant treatment regimens were described. rwEFS (time from index to first recurrence or death, whichever occurred first) and OS (time from index to death) were summarized by Kaplan–Meier analysis for overall population, by disease stage at diagnosis, and by neoadjuvant treatment modality. 221 patients (stage II, N=70; stage III, N=151) met eligibility criteria. The median follow-up from index was 32.7 months. All patients received neoadjuvant chemotherapy (51%) or chemoradiotherapy (49%) prior to surgery; 97% of patients received platinum-based regimens, among which carboplatin+paclitaxel was the most frequent (45%). In all patients, median rwEFS was 17.6 months and 5-year rwEFS was 20.9%; median OS was 48.5 months and 5-year OS was 44.9%. 71% of patients had disease recurrence during follow-up; among them, 28% developed locoregional recurrence as the first recurrence event. Patients with resected, stage II-III NSCLC who received neoadjuvant chemo/chemoradiotherapy have high rates of disease recurrence and poor survival outcomes, highlighting need for more effective treatments to improve survival rates.

中文翻译：

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已切除非小细胞肺癌的真实新辅助治疗模式和结果

目前正在研究针对局部晚期非小细胞肺癌 (NSCLC) 的新型新辅助化学免疫疗法，但新辅助治疗的实际结果知之甚少。本研究调查了美国 (US) 已切除的 II-III 期 NSCLC 患者的新辅助治疗模式、真实世界无事件生存期 (rwEFS) 和总生存期 (OS)。这项回顾性研究确定了 SEER-Medicare 数据库（2007-2019 年）中新诊断的 II、IIIA 和 IIIB (N2) 期 NSCLC（AJCC 第 8 版）接受新辅助化疗/放化疗和切除治疗的患者（索引日期：新辅助治疗开始） ）。描述了新辅助治疗方案。 rwEFS（从指数到首次复发或死亡的时间，以先发生者为准）和 OS（从指数到死亡的时间）通过 Kaplan-Meier 分析对总体人群、诊断时的疾病阶段以及新辅助治疗方式进行总结。 221 名患者（II 期，N=70；III 期，N=151）符合资格标准。指数的中位随访时间为 32.7 个月。所有患者在手术前均接受了新辅助化疗（51%）或放化疗（49%）； 97%的患者接受了以铂类为基础的治疗方案，其中卡铂+紫杉醇是最常见的（45%）。在所有患者中，中位 rwEFS 为 17.6 个月，5 年 rwEFS 为 20.9%；中位 OS 为 48.5 个月，5 年 OS 为 44.9%。 71%的患者在随访期间出现疾病复发；其中，28%的人首次出现局部复发。接受新辅助化疗/放化疗的已切除 II-III 期 NSCLC 患者的疾病复发率很高，生存结果较差，这突出表明需要更有效的治疗来提高生存率。