Photo Credit: Dr. Microbe

The following is a summary of “Impact of Chronic Obstructive Pulmonary Disease on the Efficacy and Safety of Neoadjuvant Immune Checkpoint Inhibitors Combined with Chemotherapy for Resectable non-small cell lung cancer: A Retrospective Cohort Study,” published in the January 2024 issue of Oncology by Dong et al.

This retrospective observational clinical study aimed to assess the impact of chronic obstructive pulmonary disease (COPD) on the efficacy and safety of neoadjuvant immune checkpoint inhibitors (ICIs) combined with chemotherapy in non-small cell lung cancer (NSCLC) patients. A total of 105 consecutive NSCLC patients undergoing this treatment between April 2020 and April 2023 were included. Among the 74 patients analyzed, 30 had COPD, and 44 did not. The COPD group demonstrated a significantly higher rate of pathological complete response (PCR) than the non-COPD group (43.3% vs. 20.5%, P = 0.042). 

Multivariate logistic regression confirmed that COPD presence was a statistically significant factor associated with PCR (adjusted odds ratio = 3.020, 95%CI: 1.042–8.757; P = 0.042). While other factors like major pathological response, R0 resection rate, N2 lymph node downstaging, and objective response rate did not significantly differ between the groups, the COPD group exhibited a significantly prolonged progression-free survival (PFS) compared to the non-COPD group (not reached vs. 17 months, χ² = 6.247, P = 0.012). Multivariate Cox’s regression analysis indicated that the presence of COPD was associated with a statistically significant reduction in the hazard of progression (adjusted hazard ratio = 0.321, 95% CI: 0.111–0.930; P = 0.036). Adverse events in both groups were generally manageable, with leukopenia, neutropenia, fatigue, gastrointestinal reactions, and hypothyroidism being reported. 

This study suggests that NSCLC patients with COPD may experience improved PCR, prolonged PFS, and acceptable safety when undergoing neoadjuvant ICIs combined with chemotherapy, providing valuable insights into treatment strategies for this patient population.

Source: bmccancer.biomedcentral.com/articles/10.1186/s12885-024-11902-w