Giannis Mountzios, Director of the 4th Oncology Department and Clinical Trials Unit at Henry Dunant Hospital Center, shared a post on LinkedIn:
“In ESTS26 in Athens, I had the opportunity to present the oncologist’s perspective on neoadjuvant/perioperative immunotherapy in early-stage NSCLC, together with prominent Thoracic Surgeons Jessica Donington from University of Chicago and Alessandro Brunelli from University of Leeds.
Important questions remain to be resolved:
Identification of robust biomarkers for IO efficacy in the pre-operative setting:
- Efficacy seems better in patients with high PD-L1 expression.
- TMB is not predictive of response to neoadjuvant chemo-IO.
- ctDNA clearance remains a PROGNOSTIC rather than a predictive biomarker of neoadjuvant treatment efficacy in both the chemo-IO and chemo arms.
- pCR/MPR correlate with EFS/PFS, PD-L1 correlates with pCR probability.
Do all patients need Adjuvant Immunotherapy? Prospective trials for patients with pCR in the surgical specimen?
- Role of MRD in stratifying patients for post-operative IO remains to be determined! Intensification of adjuvant treatment for patients without pCR or MRD (+)?
- Feasibility of Surgery: What about patients without response to neoadjuvant chemo-IO? Need dedicated clinical trials for this poor prognosis patient group!
Other articles about NSCLC on OncoDaily.
