Efficacy of neoadjuvant therapy for lung squamous cell carcinoma and lung adenocarcinoma: A retrospective comparative study

Gan,Yi; Liu,Zhihao; Tang,Zhiwei; Yao,Xiaojing; Zeng,Bo; Zhu,Haoshuai

doi:10.3892/ol.2023.14133

Efficacy of neoadjuvant therapy for lung squamous cell carcinoma and lung adenocarcinoma: A retrospective comparative study

Authors:
- Yi Gan
- Zhihao Liu
- Zhiwei Tang
- Xiaojing Yao
- Bo Zeng
- Haoshuai Zhu
View Affiliations

Affiliations: Department of Thoracic Surgery, The First Affiliated Hospital, Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
Published online on: November 6, 2023 https://doi.org/10.3892/ol.2023.14133
Article Number: 546
Copyright: © Gan et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Preoperative neoadjuvant therapy is widely used in cancer treatment; however, its efficacy in different subtypes of non‑small cell lung cancer (NSCLC) is unknown. The present study compared the clinical efficacy of preoperative neoadjuvant therapy for two major NSCLC subtypes. Patients with NSCLC who underwent preoperative neoadjuvant therapy between January 2016 and August 2022 were reviewed. Patients were stratified according to histology and treatment strategy. Retrospective analysis was performed by comparing the basic clinical characteristics of the patients, clinicopathological characteristics of the tumors, imaging data and pathological responses to treatment. A total of 36 cases of lung squamous cell carcinoma (LUSC) and 31 cases of lung adenocarcinoma (LUAD) were included. After neoadjuvant chemotherapy combined with immunotherapy, the pathological response rates were higher for patients with LUSC than LUAD, but there was no statistically significant difference between the two subgroups (P=0.06). However, the pathological complete response rates after neoadjuvant chemotherapy combined with immunotherapy were significantly higher for LUSC than those after chemotherapy alone (P=0.01). These preliminary findings suggested that preoperative chemotherapy combined with immunotherapy could improve the pathological response of patients, particularly in those with LUSC. The present study provided new insights into the treatment of NSCLC.

View Figures

View References

1	Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA and Jemal A: Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 68:394–424. 2018. View Article : Google Scholar : PubMed/NCBI
2	Thai AA, Solomon BJ, Sequist LV, Gainor JF and Heist RS: Lung cancer. Lancet. 398:535–554. 2021. View Article : Google Scholar : PubMed/NCBI
3	Ahmad A and Gadgeel SM: Lung cancer and personalized medicine: Novel therapies and clinical management. Adv Exp Med Biol. 890:v–vi. 2016.PubMed/NCBI
4	NSCLC Meta-analysis Collaborative Group, . Preoperative chemotherapy for non-small-cell lung cancer: A systematic review and meta-analysis of individual participant data. Lancet. 383:1561–1571. 2014. View Article : Google Scholar : PubMed/NCBI
5	Spicer J, Wang C, Tanaka F, Saylors GB, Chen KN, Liberman M, Vokes E, Girard N, Lu S, Provencio M, et al: Surgical outcomes from the phase 3 CheckMate 816 trial: Nivolumab (NIVO) + platinum-doublet chemotherapy (chemo) vs chemo alone as neoadjuvant treatment for patients with resectable non-small cell lung cancer (NSCLC). J Clin Oncol. 39 (Suppl 15):S85032021. View Article : Google Scholar
6	Wakelee HA, Altorki NK, Zhou C, Csőszi T, Vynnychenko IO, Goloborodko O, Goloborodko O, Luft A, Akopov A, Martinez-Marti A, Kenmotsu H, et al: IMpower010: Primary results of a phase III global study of atezolizumab versus best supportive care after adjuvant chemotherapy in resected stage IB-IIIA non-small cell lung cancer (NSCLC). J Clin Oncol. 39 (Suppl 15):S85002021. View Article : Google Scholar
7	Herbst RS, Morgensztern D and Boshoff C: The biology and management of non-small cell lung cancer. Nature. 553:446–454. 2018. View Article : Google Scholar : PubMed/NCBI
8	Relli V, Trerotola M, Guerra E and Alberti S: Abandoning the notion of non-small cell lung cancer. Trends Mol Med. 25:585–594. 2019. View Article : Google Scholar : PubMed/NCBI
9	Kawase A, Yoshida J, Ishii G, Nakao M, Aokage K, Hishida T, Nishimura M and Nagai K: Differences between squamous cell carcinoma and adenocarcinoma of the lung: are adenocarcinoma and squamous cell carcinoma prognostically equal? Jpn J Clin Oncol. 42:189–195. 2012. View Article : Google Scholar : PubMed/NCBI
10	Detterbeck FC, Socinski MA, Gralla RJ, Edelman MJ, Jahan TM, Loesch DM, Limentani SA, Govindan R, Zaman MB, Ye Z, et al: Neoadjuvant chemotherapy with gemcitabine-containing regimens in patients with early-stage non-small cell lung cancer. J Thorac Oncol. 3:37–45. 2008. View Article : Google Scholar : PubMed/NCBI
11	Pataer A, Weissferdt A, Vaporciyan AA, Correa AM, Sepesi B, Wistuba II, Heymach JV, Cascone T and Swisher SG: Evaluation of pathologic response in lymph nodes of patients with lung cancer receiving neoadjuvant chemotherapy. J Thorac Oncol. 16:1289–1297. 2021. View Article : Google Scholar : PubMed/NCBI
12	Forde PM, Spicer J, Lu S, Provencio M, Mitsudomi T, Awad MM, Felip E, Broderick SR, Brahmer JR, Swanson SJ, et al: Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer. N Engl J Med. 386:1973–1985. 2022. View Article : Google Scholar : PubMed/NCBI
13	Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, Nicholson AG, Groome P, Mitchell A, Bolejack V, et al: The IASLC lung cancer staging project: Proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol. 11:39–51. 2016. View Article : Google Scholar : PubMed/NCBI
14	Azam F, Latif MF, Farooq A, Tirmazy SH, AlShahrani S, Bashir S and Bukhari N: Performance status assessment by using ECOG (eastern cooperative oncology group) score for cancer patients by oncology healthcare professionals. Case Rep Oncol. 12:728–736. 2019. View Article : Google Scholar : PubMed/NCBI
15	Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, et al: New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer. 45:228–247. 2009. View Article : Google Scholar : PubMed/NCBI
16	Pataer A, Kalhor N, Correa AM, Raso MG, Erasmus JJ, Kim ES, Behrens C, Lee JJ, Roth JA, Stewart DJ, et al: Histopathologic response criteria predict survival of patients with resected lung cancer after neoadjuvant chemotherapy. J Thorac Oncol. 7:825–832. 2012. View Article : Google Scholar : PubMed/NCBI
17	Emens LA and Middleton G: The interplay of immunotherapy and chemotherapy: Harnessing potential synergies. Cancer Immunol Res. 3:436–443. 2015. View Article : Google Scholar : PubMed/NCBI
18	Provencio M, Nadal E, Insa A, García-Campelo MR, Casal-Rubio J, Dómine M, Majem M, Rodríguez-Abreu D, Martínez-Martí A, De Castro Carpeño J, et al: Neoadjuvant chemotherapy and nivolumab in resectable non-small-cell lung cancer (NADIM): An open-label, multicentre, single-arm, phase 2 trial. Lancet Oncol. 21:1413–1422. 2020. View Article : Google Scholar : PubMed/NCBI
19	Chen Z, Fillmore CM, Hammerman PS, Kim CF and Wong KK: Non-small-cell lung cancers: A heterogeneous set of diseases. Nat Rev Cancer. 14:535–546. 2014. View Article : Google Scholar : PubMed/NCBI
20	Wang BY, Huang JY, Chen HC, Lin CH, Lin SH, Hung WH and Cheng YF: The comparison between adenocarcinoma and squamous cell carcinoma in lung cancer patients. J Cancer Res Clin Oncol. 146:43–52. 2020. View Article : Google Scholar : PubMed/NCBI
21	Junker K, Thomas M, Schulmann K, Klinke F, Bosse U and Müller KM: Tumour regression in non-small-cell lung cancer following neoadjuvant therapy. Histological assessment. J Cancer Res Clin Oncol. 123:469–477. 1997. View Article : Google Scholar : PubMed/NCBI
22	Waser N, Adam A, Schweikert B, Vo L, McKenna M, Breckenridge M, Penrod JR and Goring S: 1243P Pathologic response as early endpoint for survival following neoadjuvant therapy (NEO-AT) in resectable non-small cell lung cancer (rNSCLC): Systematic literature review and meta-analysis. Ann Oncol. 31 (Suppl 4):S8062020. View Article : Google Scholar
23	Rosner S, Liu C, Forde PM and Hu C: Association of pathologic complete response and long-term survival outcomes among patients treated with neoadjuvant chemotherapy or chemoradiotherapy for NSCLC: A meta-analysis. JTO Clin Res Rep. 3:1003842022.PubMed/NCBI
24	Forde PM, Chaft JE and Pardoll DM: Neoadjuvant PD-1 blockade in resectable lung cancer. N Eng J Med. 379:e142018. View Article : Google Scholar : PubMed/NCBI
25	Gandhi L, Rodríguez-Abreu D, Gadgeel S, Esteban E, Felip E, De Angelis F, Domine M, Clingan P, Hochmair MJ, Powell SF, et al: Pembrolizumab plus chemotherapy in metastatic non-small-cell lung cancer. N Eng J Med. 378:2078–2092. 2018. View Article : Google Scholar
26	Reck M, Shankar G, Lee A, Coleman S, McCleland M, Papadimitrakopoulou VA, Socinski MA and Sandler A: Atezolizumab in combination with bevacizumab, paclitaxel and carboplatin for the first-line treatment of patients with metastatic non-squamous non-small cell lung cancer, including patients with EGFR mutations. Exp Rev Respir Med. 14:125–136. 2020. View Article : Google Scholar : PubMed/NCBI
27	Qu Y, Emoto K, Eguchi T, Aly RG, Zheng H, Chaft JE, Tan KS, Jones DR, Kris MG, Adusumilli PS and Travis WD: Pathologic assessment after neoadjuvant chemotherapy for NSCLC: Importance and implications of distinguishing adenocarcinoma from squamous cell carcinoma. J Thorac Oncol. 14:482–493. 2019. View Article : Google Scholar : PubMed/NCBI
28	Chen Q, Fu YY, Yue QN, Wu Q, Tang Y, Wang WY, Wang YS and Jiang LL: Distribution of PD-L1 expression and its relationship with clinicopathological variables: an audit from 1071 cases of surgically resected non-small cell lung cancer. Int J Clin Exp Pathol. 12:774–786. 2019.PubMed/NCBI
29	Choi NC, Carey RW, Daly W, Mathisen D, Wain J, Wright C, Lynch T, Grossbard M and Grillo H: Potential impact on survival of improved tumor downstaging and resection rate by preoperative twice-daily radiation and concurrent chemotherapy in stage IIIA non-small-cell lung cancer. J Clin Oncol. 15:712–722. 1997. View Article : Google Scholar : PubMed/NCBI
30	Travis WD, Dacic S, Wistuba I, Sholl L, Adusumilli P, Bubendorf L, Bunn P, Cascone T, Chaft J, Chen G, et al: IASLC multidisciplinary recommendations for pathologic assessment of lung cancer resection specimens after neoadjuvant therapy. J Thorac Oncol. 15:709–740. 2020. View Article : Google Scholar : PubMed/NCBI