Analysis of operability parameter changes in neoadjuvant treatment with chemotherapy and anti-PD-1/PD-L1
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The adoption of combined chemotherapy (CT) and immunotherapy (IO) has advanced neoadjuvant therapy (NA) for non-small cell lung cancer (NSCLC), but data on functional impacts are limited. This multicenter retrospective study evaluates respiratory function in NSCLC patients undergoing NA. METHODS: From 2020 to 2024, 186 patients treated with CT or CT-IO (anti-PD-1/PD-L1) were analyzed. Respiratory tests (DLCO, FEV1, FVC) pre- and post-NA were compared, alongside clinical, pathological, and surgical variables. RESULTS: Median age: 68; 66.6 % male; 93 % smokers/ex-smokers, histologies: Squamous and adenocarcinoma (46 % each), DLCO decline was greater in CT-IO vs. CT (-12.6 % vs. -7.8 %, p = 0.007) and CT-IO showed increased FEV1 (+3.8 % vs. -2.5 %, p = 0.001) and FVC (+3.7 % vs. -0.7 %, p = 0.003), surgery rate: 85.7 % (lobectomy most common at 83.3 %) and no differences in complications were found except for 9 immune-mediated events in CT-IO. CONCLUSIONS: CT-IO impacts DLCO more but improves FEV1 and FVC compared to CT. These findings warrant further validation in prospective studies.
Authors: M Sereno, A Collazo-Lorduy, Y Garitaonaindia, D Gómez de Antonio, J Baena Espinar, C Aguado de la Rosa, P Cruz Castellanos, S Falagán Martínez, LE Chara Valverde, R López-Castro, A López-Martin, J Rubio-Pérez, A Gómez Rueda, C Traseira Puchol, X Mielgo Rubio, B Losada Vila, J Rogado, E Bernal Hertfelder, L Gutiérrez Sainz, JL Campo-Cañaveral, I Romano, I. Thuissard, G Rubio Romero, E Casado Sáenz
Institutions: IMDEA Food, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, Hospital Universitario Puerta de Hierro Majadahonda, Universidad Autónoma de Madrid, Hospital Universitario 12 De Octubre, Hospital Clínico San Carlos, Hospital General Universitario de Ciudad Real, Hospital Universitario de Guadalajara, Hospital Clínico Universitario de Valladolid, Hospital Universitario Severo Ochoa, Hospital Universitario Fundación Jiménez Díaz, Hospital Universitario Ramón y Cajal, Hospital Universitario del Henares, Hospital Universitario Fundación Alcorcón, Hospital Universitario de Fuenlabrada, Hospital Universitario Infanta Leonor, Hospital Universitario Infanta Cristina, Hospital Universitario La Paz
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,740
OpenAlex ID: W4409195714