{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:37:37Z","timestamp":1794325057816,"version":"4.9.0"},"reference-count":16,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:sec id=\"ab-coi250018-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Patients with borderline resectable or unresectable stage III non\u2013small cell lung cancer (NSCLC) with T4 and\/or N2-N3 involvement face limited treatment options and poor outcomes. Neoadjuvant chemoimmunotherapy has shown promise in improving resectability and pathological responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi250018-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the efficacy of neoadjuvant programmed cell death 1 protein (PD-1) or programmed cell death 1 ligand 1 (PD-L1) blockade combined with chemotherapy in enhancing surgical outcomes and pathological responses in patients with T4 and\/or N2-N3 stage III NSCLC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi250018-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This multicenter cohort study analyzed data from patients treated between February 2018 and January 2024 with neoadjuvant PD-1\/PD-L1 inhibitors plus chemotherapy at academic and tertiary care centers across the US and Italy. Pathological and survival outcomes were assessed. Patients with stage III NSCLC and T4 and\/or N2-N3 involvement were included. Data were collected from February 2018 to January 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi250018-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>Neoadjuvant PD-1\/PD-L1 blockade combined with platinum-based chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi250018-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Pathological complete response (pCR), major pathological response, surgical resectability, and event-free survival (EFS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi250018-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 112 patients, 58 (51.8%) were female, and the median (range) age was 66 (41-84) years. A total of 84(75.0%) underwent surgical resection, achieving a pCR rate of 29.0% (24 of 83 with available final pathology) and a major pathological response rate of 42.2% (35 of 83). Patients with both PD-L1 expression of 50% or more and high tumor mutational burden achieved the highest pCR rate (4 of 9 [44.4%];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.03). Conversely, covariants in\n                      <jats:italic>KRAS<\/jats:italic>\n                      \/\n                      <jats:italic>STK11<\/jats:italic>\n                      or\n                      <jats:italic>KRAS<\/jats:italic>\n                      \/\n                      <jats:italic>KEAP1<\/jats:italic>\n                      were associated with lack of pCR. Patients with single-station or multistation N2\/N3 disease exhibited comparable pathological outcomes. The median EFS for all resected patients was 52.6 months (95% CI, 27.8 to not reached), and this was significantly longer in patients with pCR (not reached vs 27.8 months [95% CI, 19.5 to not reached];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi250018-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this study, neoadjuvant PD-1\/PD-L1 blockade combined with chemotherapy resulted in high pathological response rates and surgical resectability in patients with T4 and\/or N2-N3 stage III NSCLC. This approach offers a viable treatment option for patients with borderline resectable or unresectable NSCLC but requires further validation through prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaoncol.2025.1115","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T11:31:09Z","timestamp":1747913469000},"page":"735","source":"Crossref","is-referenced-by-count":43,"title":["Neoadjuvant PD-1 and PD-L1 Blockade With Chemotherapy for Borderline Resectable and Unresectable Stage III Non\u2013Small Cell Lung Cancer"],"prefix":"10.1001","volume":"11","author":[{"given":"Biagio","family":"Ricciuti","sequence":"first","affiliation":[{"name":"Lowe Center of Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Fusco","sequence":"additional","affiliation":[{"name":"IRCCS Regina Elena National Cancer 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