{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T21:15:34Z","timestamp":1754601334163},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Hintergrund\u2002Eine Blockade von Immun-Escape-Mechanismen (z.\u200aB. PD1\u200a\/PD-L1) mit Immun-Checkpoint-Inhibition (ICI) kann das \u00dcberleben von Patienten mit fortgeschrittenem NSCLC wesentlich verl\u00e4ngern und ausgepr\u00e4gte Remissionen induzieren. Eine neoadjuvante ICI bei Patienten mit resektablem (UICC-Stadium III) oder oligometastasiertem (UICC-Stadium IVA) NSCLC wurde bisher kaum untersucht.<\/jats:p><jats:p>\n          Patienten\/Methoden\u2002Es wurden Biopsien von Patienten mit lokal fortgeschrittenem oder oligometastasiertem NSCLC untersucht. Es erfolgte bei einer PD-L1-Expression\u200a&gt;\u200a50\u200a%, gutem ECOG-Status und zu erwartender Operabilit\u00e4t die ICI-Applikation und nach ca. 4 Wochen die thoraxchirurgische OP. Alle Patienten erhielten ein komplettes Staging einschlie\u00dflich PET-CT, cMRT und endobronchialem Ultraschall. Es wurden die Vertr\u00e4glichkeit, das radiologische und histologische Tumoransprechen und das chirurgische Outcome analysiert. <\/jats:p><jats:p>\n          Ergebnisse\u20024 Patienten (2 m\u00e4nnlich, 2 weiblich, Alter 56\u200a\u2013\u200a78 Jahre, n\u200a=\u200a3 Adenokarzinom, n\u200a=\u200a1 Plattenepithelkarzinom) erhielten pr\u00e4operativ einen ICI. Alle Patienten hatten lokal fortgeschrittene Tumore, und die mediastinalen Lymphknoten waren in 3 F\u00e4llen positiv. Bei einem Patienten lag eine isolierte Hirnmetastase vor, welche stereotaktisch radiotherapiert wurde. Alle Patienten erhielten pr\u00e4operativ komplikationslos 2\u200a\u2013\u200a6 Zyklen eines ICI (3\u200a\u00d7 Pembrolizumab; 1\u200a\u00d7 Atezolizumab). Dies f\u00fchrte nicht zu einer Verz\u00f6gerung der OP. Nach iRECIST zeigten 3 Tumore eine partielle response (PR), und ein Patient wies ein stable disease (SD) auf. Alle Tumore wurden komplett reseziert, und die OP erwies sich trotz inflammatorischer Ver\u00e4nderungen als technisch unproblematisch. Es gab keine behandlungsbezogene Morbidit\u00e4t oder Mortalit\u00e4t und keine perioperativen Komplikationen. In den Resektaten waren jeweils 2-mal ein komplettes pathologisches Ansprechen (CPR), Regressionsgrad III nach Junker, und 2-mal ein Regressionsgrad IIa nach Junker nachweisbar. Das mittlere Follow-up betrug 12 (1\u200a\u2013\u200a24) Monate. Die PPR-Patienten entwickelten entweder Fernmetastasen nach 6 Monaten oder ein Lokalrezidiv nach 4 Monaten. Die CPR-Patienten sind bisher rezidivfrei. <\/jats:p><jats:p>\n          Schlussfolgerungen\u2002Eine neoadjuvante Therapie mit ICI ist gut vertr\u00e4glich und kann bei ausgew\u00e4hlten Patienten eine komplette Tumorremission induzieren. Die Behandlung hat keinen negativen Einfluss auf den chirurgischen Eingriff. Die Prognose ist vielversprechend bei CPR und eingeschr\u00e4nkt bei PPR. <\/jats:p>","DOI":"10.1055\/a-1199-2029","type":"journal-article","created":{"date-parts":[[2020,8,21]],"date-time":"2020-08-21T00:06:27Z","timestamp":1597968387000},"page":"766-772","source":"Crossref","is-referenced-by-count":3,"title":["Operabilit\u00e4t und pathologisches Ansprechen des Lungenkarzinoms nach neoadjuvanter Therapie mit Immun-Checkpoint-Inhibitoren"],"prefix":"10.1055","volume":"74","author":[{"given":"E.","family":"L\u00fccke","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Pneumologie, Otto-von-Guericke-Universit\u00e4t Magdeburg, Magdeburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Ganzert","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Pneumologie, Otto-von-Guericke-Universit\u00e4t Magdeburg, Magdeburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"F\u00f6llner","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Pneumologie, Otto-von-Guericke-Universit\u00e4t Magdeburg, Magdeburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"W\u00e4sche","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Pneumologie, Otto-von-Guericke-Universit\u00e4t Magdeburg, Magdeburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Jechorek","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pathologie, Otto-von-Guericke-Universit\u00e4t Magdeburg, Magdeburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V.","family":"Schoeder","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pathologie, Otto-von-Guericke-Universit\u00e4t Magdeburg, Magdeburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Walles","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Herz- und Thoraxchirurgie, Abteilung Thoraxchirurgie, Otto-von-Guericke-Universit\u00e4t Magdeburg, Magdeburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Genseke","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Radiologie und Nuklearmedizin, Otto-von-Guericke-Universit\u00e4t Magdeburg, Magdeburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Pneumologie, Otto-von-Guericke-Universit\u00e4t Magdeburg, Magdeburg"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,8,20]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1097\/JTO.0b013e31818020eb","article-title":"The International 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