{"doi":"10.3389/fimmu.2023.1343504","title":"Comparison of neoadjuvant chemoimmunotherapy and chemotherapy alone for resectable stage III non-small cell lung cancer: a real-world cohort study","abstract":"<jats:sec><jats:title>Background</jats:title><jats:p>We compared the real-world efficacy and safety of neoadjuvant chemoimmunotherapy to chemotherapy alone in patients with stage III non-small-cell lung cancer (NSCLC).</jats:p></jats:sec><jats:sec><jats:title>Participants and methods</jats:title><jats:p>A total of 59 consecutive patients were finally selected and divided into two groups: the neoadjuvant chemotherapy group (n = 33) and the neoadjuvant chemoimmunotherapy group (n = 26). The primary endpoint was disease-free survival (DFS). The secondary endpoints were pathological response, clinical response, and adverse events. All patients were followed up to collect perioperative pathology and clinical data.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The objective response rate (ORR), pathological complete response (pCR), and major pathological response (MPR) were significantly higher in the neoadjuvant chemoimmunotherapy group than in the neoadjuvant chemotherapy group (73.1% vs. 45.5%, 34.6% vs. 3.0%, and 65.3% vs. 15.1%, respectively; <jats:italic>P</jats:italic> &amp;lt; 0.05<jats:italic>)</jats:italic>. There was no statistically significant difference in disease-free survival between the neoadjuvant chemoimmunotherapy and neoadjuvant chemotherapy groups (<jats:italic>P</jats:italic> = 0.129). Patients in the neoadjuvant chemoimmunotherapy group had a higher rate of tumor regression than those in neoadjuvant chemotherapy group (37.0% [25 patients] vs. 29.0% [33 patients], <jats:italic>P =</jats:italic> 0.018). However, no discernible correlation between MPR achievement and the degree of tumor shrinkage was observed in either group (<jats:italic>P</jats:italic> &amp;gt; 0.05). The cumulative MPR rates were 42.3, 50, and 65.3% for 2, 3, and ≥ 4 cycles, respectively, in the neoadjuvant chemoimmunotherapy group and 9.1, 12.1, and 15.1% for ≤ 2, 3, and ≥ 4 cycles, respectively, in the neoadjuvant chemotherapy group. Moreover, No statistical difference was observed between the two groups regarding postoperative complications, resection range, operation time, surgical method, and extent of resection (<jats:italic>P</jats:italic> &amp;gt; 0.05). Although the incidence of grades III–IV adverse events was higher in the neoadjuvant chemotherapy group than in the neoadjuvant chemoimmunotherapy group (33.3% vs. 4.6%, <jats:italic>P</jats:italic> = 0.042), there was no significant difference in the incidence of adverse events between the two groups (64.6% vs. 83.6%, <jats:italic>P</jats:italic> = 0.072).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>In stage III NSCLC, neoadjuvant chemoimmunotherapy achieved higher pathological and clinical remission rates than chemotherapy alone, with compromising safety, making it an attractive choice for neoadjuvant therapy.</jats:p></jats:sec>","journal":"Frontiers in Immunology","year":2023,"id":684103,"datarank":0.24141568686511508,"base_score":1.6094379124341003,"endowment":1.6094379124341003,"self_citation_contribution":0.24141568686511508,"citation_network_contribution":0.0,"self_endowment_contribution":0.24141568686511508,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":831967,"name":"Yi Liu","orcid":"0000-0002-7782-4548","position":1,"is_corresponding":false},{"id":1728505,"name":"Kejun Liu","orcid":null,"position":2,"is_corresponding":false},{"id":1452656,"name":"Junkai Zhang","orcid":"0000-0002-6407-6173","position":3,"is_corresponding":false},{"id":1787187,"name":"Hanlin Liang","orcid":null,"position":4,"is_corresponding":false},{"id":1787188,"name":"Yingmeng Wu","orcid":null,"position":5,"is_corresponding":false},{"id":1787189,"name":"Hongyu Ye","orcid":null,"position":6,"is_corresponding":false},{"id":22190,"name":"Yi Liang","orcid":"0000-0002-4814-0761","position":7,"is_corresponding":false},{"id":300977,"name":"Jingjing Zhang","orcid":"0000-0002-7953-1159","position":8,"is_corresponding":false},{"id":1787190,"name":"Weizhao Huang","orcid":null,"position":9,"is_corresponding":false},{"id":1787185,"name":"Sihao Zhou","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Comparison of neoadjuvant chemoimmunotherapy and chemotherapy alone for resectable stage III non-small cell lung cancer: a real-world cohort study","abstract":"<jats:sec><jats:title>Background</jats:title><jats:p>We compared the real-world efficacy and safety of neoadjuvant chemoimmunotherapy to chemotherapy alone in patients with stage III non-small-cell lung cancer (NSCLC).</jats:p></jats:sec><jats:sec><jats:title>Participants and methods</jats:title><jats:p>A total of 59 consecutive patients were finally selected and divided into two groups: the neoadjuvant chemotherapy group (n = 33) and the neoadjuvant chemoimmunotherapy group (n = 26). The primary endpoint was disease-free survival (DFS). The secondary endpoints were pathological response, clinical response, and adverse events. All patients were followed up to collect perioperative pathology and clinical data.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The objective response rate (ORR), pathological complete response (pCR), and major pathological response (MPR) were significantly higher in the neoadjuvant chemoimmunotherapy group than in the neoadjuvant chemotherapy group (73.1% vs. 45.5%, 34.6% vs. 3.0%, and 65.3% vs. 15.1%, respectively; <jats:italic>P</jats:italic> &amp;lt; 0.05<jats:italic>)</jats:italic>. There was no statistically significant difference in disease-free survival between the neoadjuvant chemoimmunotherapy and neoadjuvant chemotherapy groups (<jats:italic>P</jats:italic> = 0.129). Patients in the neoadjuvant chemoimmunotherapy group had a higher rate of tumor regression than those in neoadjuvant chemotherapy group (37.0% [25 patients] vs. 29.0% [33 patients], <jats:italic>P =</jats:italic> 0.018). However, no discernible correlation between MPR achievement and the degree of tumor shrinkage was observed in either group (<jats:italic>P</jats:italic> &amp;gt; 0.05). The cumulative MPR rates were 42.3, 50, and 65.3% for 2, 3, and ≥ 4 cycles, respectively, in the neoadjuvant chemoimmunotherapy group and 9.1, 12.1, and 15.1% for ≤ 2, 3, and ≥ 4 cycles, respectively, in the neoadjuvant chemotherapy group. Moreover, No statistical difference was observed between the two groups regarding postoperative complications, resection range, operation time, surgical method, and extent of resection (<jats:italic>P</jats:italic> &amp;gt; 0.05). Although the incidence of grades III–IV adverse events was higher in the neoadjuvant chemotherapy group than in the neoadjuvant chemoimmunotherapy group (33.3% vs. 4.6%, <jats:italic>P</jats:italic> = 0.042), there was no significant difference in the incidence of adverse events between the two groups (64.6% vs. 83.6%, <jats:italic>P</jats:italic> = 0.072).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>In stage III NSCLC, neoadjuvant chemoimmunotherapy achieved higher pathological and clinical remission rates than chemotherapy alone, with compromising safety, making it an attractive choice for neoadjuvant therapy.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":1.6094379124341003,"endowment":1.6094379124341003,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"38187385","pmcid":"PMC10770829","openalex_id":"https://openalex.org/W4390111418","authors":[],"funders":[],"total_grants":0,"fwci":0.652,"citation_percentile":0.7070832,"influential_citations":0,"citation_trend":[{"year":2024,"count":1},{"year":2025,"count":1},{"year":2026,"count":2}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://www.frontiersin.org/articles/10.3389/fimmu.2023.1343504/pdf?isPublishedV2=False","host_type":"journal"},{"url":"https://www.frontiersin.org/articles/10.3389/fimmu.2023.1343504/pdf?isPublishedV2=False","host_type":"publisher"},{"url":"https://www.frontiersin.org/articles/10.3389/fimmu.2023.1343504/full","host_type":"publisher"},{"url":"https://doi.org/10.3389/fimmu.2023.1343504","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/38187385","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10770829","host_type":"repository"},{"url":"https://doaj.org/article/3ed130a5e97c45a7a30aeb0b9d64c490","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10770829/pdf/fimmu-14-1343504.pdf","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC10770829","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC10770829?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Lung Cancer Diagnosis and Treatment","Lung Cancer Research Studies","Lung Cancer Treatments and Mutations","Humans","Carcinoma, Non-Small-Cell Lung","Neoadjuvant Therapy","Cohort Studies","Lung Neoplasms","Disease-Free Survival"],"mesh_terms":["Carcinoma, Non-Small-Cell Lung","Humans","Lung Neoplasms","Cohort Studies","Disease-Free Survival","Neoadjuvant Therapy"],"keywords":["Chemoimmunotherapy","Medicine","Neoadjuvant therapy","Chemotherapy","Internal medicine","Perioperative","Oncology","Stage (stratigraphy)","Lung cancer","Cancer","Gastroenterology","Surgery","Cyclophosphamide","Breast cancer","Safety","Immunotherapy","non-small-cell lung cancer","efficacy"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"nct"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-18T13:18:43.313773Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}