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Neoadjuvant Combination Immunotherapy Improves Outcomes For Early Stage Non-small Cell Lung Cancer

(MD Anderson) Feb 18, 2021 - The first randomized Phase II clinical trial to report on single and combined neoadjuvant immune checkpoint inhibitor therapy in stage I-III non-small cell lung cancer (NSCLC) found combination therapy produced a significant clinical benefit, as assessed by major pathologic response (MPR) rate, as well as enhanced tumor immune cell infiltration and immunological memory. Researchers from The University of Texas MD Anderson Cancer Center published the study results today in Nature Medicine.

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H. Jack West, MD (Posted: February 20, 2021)

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Though there is a lot of focus on neoadjuvant immunotherapy for lung cancer, many if not most practicing oncologists will be seeking more established endpoints like a significant improvement in overall survival, or at least disease-free survival, rather than focusing on relatively newer variables like major pathological response that have been "retrofitted" as an endpoint of choice because they show a benefit quickly.

Neoadjuvant immunotherapy or chemoimmunotherapy should generate great enthusiasm and become a new standard of care if and when it produces improvements in established endpoints in prospective, randomized phase 3 trials -- not before that. Immunologic endpoints don't counterbalance the side effects and costs of immunotherapy.

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Tomasz M. Beer, MD, FACP

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Dean Gesme, MD

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