Alejandra Romero Román1, Jose Luis Campo-Cañaveral de la Cruz1, Iván Macía1, Ignacio Escobar Campuzano1,2,3, Santiago Figueroa Almánzar4, María Delgado Roel5, Carlos Gálvez Muñoz6, Eva M García Fontán7, Ignacio Muguruza Trueba8, Laura Romero Vielva9, José Ramón Cano Garcia10, Elisabeth Martínez Téllez11, Concepción Partida González12, Marcelo Fernando Jiménez López13, Unai Jiménez Maestre14, Roberto Mongil Poce15, David Sánchez Lorente16, Antonio Álvarez Kindelán17, Mariano Provencio Pulla18. 1. Department of Thoracic Surgery, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain. 2. Department of Thoracic Surgery, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) and Unit of Human Anatomy and Embryology, Department of Pathology and Experimental Therapeutics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain. 3. Department of Thoracic Surgery, Hospital Universitari de Bellvitge;, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) and Department of Clinical Sciences, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain. 4. Department of Thoracic Surgery, Hospital Clinic Universitari de València, Valencia, Spain. 5. Department of Thoracic Surgery, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain. 6. Department of Thoracic Surgery, Hospital General Universitario de Alicante, Alicante, Spain. 7. Department of Thoracic Surgery, Complejo Universitario de Vigo, Vigo, Spain. 8. Department of Thoracic Surgery, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain. 9. Department of Thoracic Surgery, Hospital Vall d'Hebrón, Barcelona, Spain. 10. Department of Thoracic Surgery, Complejo Hospitalario Universitario Insular de Gran Canaria, Las Palmas, Spain. 11. Department of Thoracic Surgery, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain. 12. Department of Thoracic Surgery, Hospital Universitario La Paz, Madrid, Spain. 13. Department of Thoracic Surgery, Hospital Universitario de Salamanca, Salamanca, Spain. 14. Department of Thoracic Surgery, Hospital Universitario de Cruces, Bizkaia, Spain. 15. Department of Thoracic Surgery, Hospital Regional Universitario de Málaga, Málaga, Spain. 16. Department of Thoracic Surgery, Hospital Clinic i Provincial de Barcelona, Barcelona, Spain. 17. Department of Thoracic Surgery, Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain. 18. Department of Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.
Abstract
OBJECTIVES: This analysis aimed to evaluate perioperative outcomes of surgical resection following neoadjuvant treatment with chemotherapy plus nivolumab in resectable stage IIIA non-small-cell lung cancer. METHODS: Eligible patients received neoadjuvant chemotherapy (paclitaxel + carboplatin) plus nivolumab for 3 cycles. Reassessment of the tumour was carried out after treatment and patients with at least stable disease as best response underwent pulmonary resection. After surgery, patients received adjuvant treatment with nivolumab for 1 year. Surgical data were collected from the NADIM database and patient charts were reviewed for additional surgical details. RESULTS: Among 46 patients who received neoadjuvant treatment, 41 (89.1%) underwent surgery. Two patients rejected surgery and 3 did not fulfil resectability criteria. There were 35 lobectomies (85.3%), 3 of which were sleeve lobectomies (9.4%), 3 bilobectomies (7.3%) and 3 pneumonectomies (7.3%). Video-assisted thoracoscopy was the initial approach in 51.2% of cases, with a conversion rate of 19% (n = 4). There was no operative mortality at either 30 or 90 days. The most common complications were prolonged air leak (n = 8), pneumonia (n = 5) and arrhythmia (n = 4). Complete resection (R0) was achieved in all patients who underwent surgery, downstaging was observed in 37 patients (90.2%) and major pathological response in 34 patients (82.9%). CONCLUSIONS: Surgical resection following induction therapy with chemotherapy plus nivolumab appears to be safe and offers appropriate oncological outcomes. Perioperative morbidity and mortality rates in our study were no higher than previously reported in this setting. A minimally invasive approach is, therefore, feasible.
OBJECTIVES: This analysis aimed to evaluate perioperative outcomes of surgical resection following neoadjuvant treatment with chemotherapy plus nivolumab in resectable stage IIIA non-small-cell lung cancer. METHODS: Eligible patients received neoadjuvant chemotherapy (paclitaxel + carboplatin) plus nivolumab for 3 cycles. Reassessment of the tumour was carried out after treatment and patients with at least stable disease as best response underwent pulmonary resection. After surgery, patients received adjuvant treatment with nivolumab for 1 year. Surgical data were collected from the NADIM database and patient charts were reviewed for additional surgical details. RESULTS: Among 46 patients who received neoadjuvant treatment, 41 (89.1%) underwent surgery. Two patients rejected surgery and 3 did not fulfil resectability criteria. There were 35 lobectomies (85.3%), 3 of which were sleeve lobectomies (9.4%), 3 bilobectomies (7.3%) and 3 pneumonectomies (7.3%). Video-assisted thoracoscopy was the initial approach in 51.2% of cases, with a conversion rate of 19% (n = 4). There was no operative mortality at either 30 or 90 days. The most common complications were prolonged air leak (n = 8), pneumonia (n = 5) and arrhythmia (n = 4). Complete resection (R0) was achieved in all patients who underwent surgery, downstaging was observed in 37 patients (90.2%) and major pathological response in 34 patients (82.9%). CONCLUSIONS: Surgical resection following induction therapy with chemotherapy plus nivolumab appears to be safe and offers appropriate oncological outcomes. Perioperative morbidity and mortality rates in our study were no higher than previously reported in this setting. A minimally invasive approach is, therefore, feasible.
Authors: Christopher A Lemmon; Gregory M M Videtic; Sudish Murthy; Kevin L Stephans; Marc Shapiro; Usman Ahmad; Daniel Raymond; Vamsidhar Velcheti; Alejandro Bribriesco; Xuefei Jia; James Stevenson; Nathan A Pennell Journal: JTO Clin Res Rep Date: 2022-06-15
Authors: Christopher Cao; Anthony Le; Matthew Bott; Chi-Fu Jeffrey Yang; Dominique Gossot; Franca Melfi; David H Tian; Allen Guo Journal: Curr Oncol Date: 2021-11-14 Impact factor: 3.109
Authors: Andrew Tang; Andrew Feczko; Sudish C Murthy; Siva Raja; Alejandro Bribriesco; Dean Schraufnagel; Usman Ahmad; Daniel P Raymond; Monisha Sudarshan Journal: JTCVS Open Date: 2022-02-23