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Main results from Phase 3 randomized trials on induction immune checkpoint inhibitors for resectable non–small cell lung cancer (NSCLC) Neoadjuvant or perioperative (neoadjuvant + adjuvant) | Study | Neoadjuvant | N | Adjuvant | Stage | Primary end point | Preoperative patient attrition | DFS or EFS HR | OS HR | DFS or EFS | OS | R0 | pCR | | AEGEAN[4 | Durvalumab + CT vs CT (4 cycles; 12 wk) | 802 | Durvalumab vs supportive care | IIA-IIIB | pCR
EFS | 19% vs 19% | 0.68 (P < .004) | NR | 73.2% vs 63% at 2 y | NR | 94.7% vs 91.3% | 17.2% vs 4.3% | | Checkmate 816[2 | Nivolumab + CT vs CT (3 cycles) | 358 | None | IB-IIIA | pCR
EFS | 16% vs 21% | 0.63; 97.38% CI, 0.43-0.91; P = .005 | 0.57 (99.67% CI, 0.30-1.07) | Median EFS 31.6 mo vs 20.8 mo | 83% at 2 y
78% at 3 y | 83.2% vs 77.8% | 24% vs 2.2% | | Keynote 671[5 | Pembrolizumab + CT vs CT (4 cycles; 12 wk) | 797 | Pembrolizumab vs supportive care | II-IIIB | EFS
OS | 18% vs 21% | HR, 0.58 (95% CI, 0.46-0.72); P < .00001 | HR, 0.73 (95% CI, 0.54-0.99); P = .02124 | (2-y EFS rate, 62.4% vs 40.6% | NR | 92% vs 84.2% | 18.1% vs 4% | | Neotorch[20 | Toripalimab + CT vs CT (3 cycles) | 404 | Toripalimab vs supportive care after 1 cycle CT | II-III | EFS
MPR | 18% vs 27% | HR, 0.40 (95% CI (0.277-0.565); P < .0001 | NR | Median NR vs 15.1 mo | NR | 95.8% vs 92.6% | 24.8% vs 1% |
DFS, Disease-free survival; EFS, event-free survival; HR, hazard ratio; OS, overall survival; pCR, pathological complete response; CT, chemotherapy; NR, not reported. 围术期免疫治疗研究汇总（2024-12）
围术期不同模式下的总生存期OS
IMpower 010： 中位随访 65月; HR 0.77； 5年OS： 75% vs 66%
CheckMate 816：中位随访 68月；HR 0.72; 5年OS：65% vs 55%
KEYNOTE-671： 中位随访 60.4月； HR 0.74； 5年OS： 64.6% vs 53.6%
结论：围术期免疫治疗相比新辅助免疫治疗OS获益相似。
Etienne H, Battilana B, Spicer J, Werner RS, Opitz I. Defining resectability: When do you try to take it out? JTCVS Open. 2024 Mar 29;19:338-346. doi: 10.1016/j.xjon.2024.03.012. PMID: 39015436; PMCID: PMC11247203.
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