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Here, we report findings from LungMate\u2010006, the first prospective Phase II trial evaluating PD\u20101 blockade with tislelizumab combined with platinum\u2013etoposide in LD\u2010SCLC. Among 15 enrolled patients, the regimen achieved an objective response rate of 66.7% and enabled curative\u2010intent surgery in 60% of patients, all with R0 resection. Major pathological response and pathological complete response occurred in 44.4% and 33.3% of surgical cases, respectively. Median event\u2010free and overall survival reached 21.7 and 32.7\u00a0months. Metabolic response by PET\u2010CT more accurately predicted pathological remission than radiographic shrinkage alone. Bulk RNA sequencing revealed a treatment\u2010induced transition from a metabolically active baseline state toward an extracellular matrix\u2013remodeled, CAF\u2010 and macrophage\u2010enriched microenvironment, alongside upregulation of genes associated with tumor stemness and immune evasion. These transcriptomic changes suggest stromal\u2013myeloid\u2013mediated adaptive resistance in non\u2010MPR tumors and highlight potential avenues for refining perioperative immunochemotherapy strategies in SCLC.<\/jats:p>","DOI":"10.1002\/mco2.70972","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:55:47Z","timestamp":1788504947000},"source":"Crossref","is-referenced-by-count":0,"title":["Neoadjuvant PD\u20101 Blockade Tislelizumab (BGB\u2010A317) in Combination With Etoposide and Platinum\u2010Based Chemotherapy for Limited\u2010Disease Small Cell Lung Cancer"],"prefix":"10.1002","volume":"7","author":[{"given":"Shiyue","family":"Wan","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery Shanghai Pulmonary Hospital Tongji University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiqi","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Thoracic 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