Neoadjuvant Nivolumab and Chemotherapy in Patients with Locally Advanced Non-Small Cell Lung Cancer: A Retrospective Study

Figures & data

Table 1 Patient Characteristics

Characteristics	Patients (n = 46)
Age	63 (56–73)
Sex
Male	26 (56.5%)
Female	20 (43.5%)
History of smoking
Current/ex-smoker	43 (93.5%)
Never-smoker	3 (6.5%)
ECOG PS
0	17 (37.0%)
1	29 (63.0%)
BMI, kg/m^2	24.51 (24.12–28.62)
Pathological type
Squamous carcinoma	27 (58.7%)
Adenocarcinoma	19 (41.3%)
Clinical T stage
T1	4
T2	11
T3	16
T4	15
Clinical N stage
N0	10
N1	15
N2	21
Clinical stage
IIIA	30 (65.2%)
IIIB	16 (34.8%)
PD-L1 expression
<1%	16 (34.8%)
1–50%	18 (39.1%)
≥50%	12 (26.1%)
Adjuvant nivolumab (at least 1 cycle)	34 (73.9%)

Abbreviations: BMI, body mass index; PD-L1, programmed death-ligand 1.

Table 2 Surgical Procedures

Characteristics	Patients (n = 45)
Type of surgery
Video-assisted thoracoscopic surgery	29 (64.4%)
Thoracotomy	16 (35.6%)
Surgical resection
Lobectomy	32 (71.1%)
Bilobectomy	10 (22.2%)
Pneumonectomy	3 (6.7%)
Operation time, min	220 (70–360)
Bleeding, mL	190 (60–560)
Hospital stay, days	8 (4–18)
Resection margins
R0	43 (95.6%)
R1	2 (4.4%)
R2	0 (0%)
Surgical complications
Intraoperative blood transfusion	4 (8.9%)
30- and 90-day mortality	0 (0%)
Postoperative arrhythmia	1 (2.2%)
Urinary tract infection or urinary retention	2 (4.4%)

Table 3 Radiologic Responses and Pathologic Responses

Characteristics	Patients (n = 46)
Radiologic responses
Complete response	2 (4.3%)
Partial response	26 (56.5%)
Stable disease	17 (37.0%)
Progression disease	1 (2.2%)
Pathologic responses
Incomplete pathological response	14 (30.4%)
Major pathological response	8 (17.4%)
Complete pathological response	24 (52.2%)
Pathological T down-staging	36 (78.2%)
Pathological N down-staging (to N1 or N0)	30 (65.2%)

Figure 1 Kaplan-Meier survival curves in all patients. (A) Disease-free survival. (B) Overall survival.

Table 4 Treatment-Related Adverse Events During Neoadjuvant Treatment (n = 46)

	Grade 1–2	Grade 3	Grade 4
Any treatment-related adverse event	38 (82.6%)	9 (19.6%)
Anemia	6 (13.0%)
Leukopenia	13 (28.3%)
Neutropenia	13 (28.3%)
Thrombocytopenia	11 (23.9%)
Anorexia	12 (6.7%)	2 (4.3%)
Vomiting	10 (21.7%)	1 (2.2%)
Diarrhea	5 (10.9%)
Constipation	3 (6.5%)
Fatigue	15 (32.6%)	3 (6.5%)
Alopecia	14 (30.4%)	2 (4.3%)
Hypothyroidism	3 (6.5%)
Rash	2 (4.3%)
Hyperglycemia	2 (4.3%)
Arthralgia or myalgia	3 (6.5%)	1 (2.2%)

Figure 2 Kaplan-Meier survival curves stratified by pathological responses. (A and B) Disease-free survival (A) and overall survival (B) based on major pathological response. (C and D) Disease-free survival (C) and overall survival (D) based on complete pathological response.

Figure 3 Kaplan-Meier survival curves stratified by PD-L1 expression or adjuvant nivolumab. (A and B) Disease-free survival (A) and overall survival (B) based on PD-L1 expression. (C and D) Disease-free survival (C) and overall survival (D) based on adjuvant nivolumab.