Survival benefit of neoadjuvant therapies in patients with surgically resected non-small cell lung cancer with pathologic complete response.

Authors

• Isheeta Madeka
• Khaled Noueihed
• Jonathan Martin
• Scott H Koeneman
• Jacob Woodroof
• Hamza Rshaidat
• Gregory L Whitehorn
• Sneha Alaparthi
• Tyler R Grenda
• Nathaniel R Evans
• Olugbenga T Okusanya

Publication/Presentation Date

7-31-2026

Abstract

BACKGROUND: Although the prognostic value of pathologic complete response (pCR) status has varied based on neoadjuvant strategy for operable, advanced non-small cell lung cancer (NSCLC), its value after neoadjuvant chemoimmunotherapy as compared to the other strategies is unknown. We aim to investigate the long-term survival benefits in patients receiving neoadjuvant chemotherapy alone, chemoradiation, or chemoimmunotherapy for surgically resected NSCLC with pCR.

METHODS: A retrospective cohort review was completed utilizing the National Cancer Database from 2017-2020. Patients with cT1B-3A NSCLC who received neoadjuvant therapy prior to surgical resection, and pCR were included. Basic demographic information, short-term outcomes, and available surgical data were collected. Long-term outcomes were assessed via Kaplan-Meier analysis with log-rank tests and multivariable regression analysis.

RESULTS: We identified 584 patients between 2017 and 2020. A majority presented with clinical stage III NSCLC (64.4%, n=376) and underwent lobectomy (86.9%, n=505). A majority received chemoradiation (59.8%, n=349), followed by chemotherapy alone (25%, n=146) and chemoimmunotherapy (15.2%, n=89). There was a significant association with improved 5-year overall survival (OS) in patients who achieved PCR status between chemoimmunotherapy (84.4%) and chemoradiation (70%) (P< 0.05). There was no significant difference in OS between neoadjuvant chemoimmunotherapy (84.4%)

CONCLUSIONS: In patients with NSCLC with pCR, there was a significantly greater association of OS in patients who received neoadjuvant chemoimmunotherapy compared to those who received chemoradiation. There was no significant survival difference between chemoimmunotherapy and chemotherapy alone.

Volume

18

Issue

7

First Page

756

Last Page

756

ISSN

2072-1439

Published In/Presented At

Madeka, I., Noueihed, K., Martin, J., Koeneman, S. H., Woodroof, J., Rshaidat, H., Whitehorn, G. L., Alaparthi, S., Grenda, T. R., Evans, N. R., 3rd, & Okusanya, O. T. (2026). Survival benefit of neoadjuvant therapies in patients with surgically resected non-small cell lung cancer with pathologic complete response. Journal of thoracic disease, 18(7), 756. https://doi.org/10.21037/jtd-2026-1-0172

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

42583282

Department(s)

Administration and Leadership

Document Type

Article