{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:01:05Z","timestamp":1787508065183,"version":"build-2736575974"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T00:00:00Z","timestamp":1703203200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We compared the real-world efficacy and safety of neoadjuvant chemoimmunotherapy to chemotherapy alone in patients with stage III non-small-cell lung cancer (NSCLC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants and methods<\/jats:title>\n                    <jats:p>A total of 59 consecutive patients were finally selected and divided into two groups: the neoadjuvant chemotherapy group (n = 33) and the neoadjuvant chemoimmunotherapy group (n = 26). The primary endpoint was disease-free survival (DFS). The secondary endpoints were pathological response, clinical response, and adverse events. All patients were followed up to collect perioperative pathology and clinical data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The objective response rate (ORR), pathological complete response (pCR), and major pathological response (MPR) were significantly higher in the neoadjuvant chemoimmunotherapy group than in the neoadjuvant chemotherapy group (73.1% vs. 45.5%, 34.6% vs. 3.0%, and 65.3% vs. 15.1%, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05\n                      <jats:italic>)<\/jats:italic>\n                      . There was no statistically significant difference in disease-free survival between the neoadjuvant chemoimmunotherapy and neoadjuvant chemotherapy groups (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.129). Patients in the neoadjuvant chemoimmunotherapy group had a higher rate of tumor regression than those in neoadjuvant chemotherapy group (37.0% [25 patients] vs. 29.0% [33 patients],\n                      <jats:italic>P =<\/jats:italic>\n                      0.018). However, no discernible correlation between MPR achievement and the degree of tumor shrinkage was observed in either group (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt; 0.05). The cumulative MPR rates were 42.3, 50, and 65.3% for 2, 3, and \u2265 4 cycles, respectively, in the neoadjuvant chemoimmunotherapy group and 9.1, 12.1, and 15.1% for \u2264 2, 3, and \u2265 4 cycles, respectively, in the neoadjuvant chemotherapy group. Moreover, No statistical difference was observed between the two groups regarding postoperative complications, resection range, operation time, surgical method, and extent of resection (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt; 0.05). Although the incidence of grades III\u2013IV adverse events was higher in the neoadjuvant chemotherapy group than in the neoadjuvant chemoimmunotherapy group (33.3% vs. 4.6%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.042), there was no significant difference in the incidence of adverse events between the two groups (64.6% vs. 83.6%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.072).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In stage III NSCLC, neoadjuvant chemoimmunotherapy achieved higher pathological and clinical remission rates than chemotherapy alone, with compromising safety, making it an attractive choice for neoadjuvant therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2023.1343504","type":"journal-article","created":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T23:29:43Z","timestamp":1703201383000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of neoadjuvant chemoimmunotherapy and chemotherapy alone for resectable stage III non-small cell lung cancer: a real-world cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Sihao","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kejun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junkai","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanlin","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingmeng","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyu","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weizhao","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.jtho.2015.09.009","article-title":"The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer","volume":"11","author":"Goldstraw","year":"2016","journal-title":"J Thorac Oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2020.03.23","article-title":"Adjuvant therapy in stage IIIA-N2 non-small cell lung cancer after neoadjuvant concurrent chemoradiotherapy followed by surgery","volume":"12","author":"Shin","year":"2020","journal-title":"J Thorac Dis"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2023.0020","article-title":"NCCN guidelines\u00ae Insights: non-small cell lung cancer, version 2.2023","volume":"21","author":"Ettinger","year":"2023","journal-title":"J Natl Compr Canc Netw"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1)","volume":"45","author":"Eisenhauer","year":"2009","journal-title":"Eur J Cancer"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e318247504a","article-title":"Histopathologic response criteria predict survival of patients with resected lung cancer after neoadjuvant chemotherapy","volume":"7","author":"Pataer","year":"2012","journal-title":"J Thorac Oncol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdy218","article-title":"Pathologic features of response to neoadjuvant anti-PD-1 in resected non-small-cell lung carcinoma: a proposal for quantitative immune-related pathologic response criteria (irPRC)","volume":"29","author":"Cottrell","year":"2018","journal-title":"Ann Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.canlet.2018.01.050","article-title":"Immunogenic chemotherapy: Dose and schedule dependence and combination with immunotherapy","volume":"419","author":"Wu","year":"2018","journal-title":"Cancer Lett"},{"key":"B8","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1038\/cdd.2013.67","article-title":"Immune-based mechanisms of cytotoxic chemotherapy: implications for the design of novel and rationale-based combined treatments against cancer","volume":"21","author":"Bracci","year":"2014","journal-title":"Cell Death Differ"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.4889","article-title":"A real-world comparison between neoadjuvant chemoimmunotherapy and chemotherapy alone for resectable non-small cell lung cancer","volume":"12","author":"Zhang","year":"2023","journal-title":"Cancer Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.1022123","article-title":"Neoadjuvant immunotherapy combined with chemotherapy significantly improved patients' overall survival when compared with neoadjuvant chemotherapy in non-small cell lung cancer: a cohort study","volume":"12","author":"Dai","year":"2022","journal-title":"Front Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2021.39.15_suppl.8503","article-title":"Surgical outcomes from the phase 3 CheckMate 816 trial: nivolumab (NIVO) + platinum-doublet chemotherapy (chemo) vs chemo alone as neoadjuvant treatment for patients with resectable non-small cell lung cancer (NSCLC)","volume":"39","author":"Spicer","year":"2021","journal-title":"J Clin Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2215530","article-title":"Perioperative nivolumab and chemotherapy in stage III non-small-cell lung cancer","volume":"389","author":"Provencio","year":"2023","journal-title":"N Engl J Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70334-6","article-title":"Pathological response after neoadjuvant chemotherapy in resectable non-small-cell lung cancers: proposal for the use of major pathological response as a surrogate endpoint","volume":"15","author":"Hellmann","year":"2014","journal-title":"Lancet Oncol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"CT005","DOI":"10.1158\/1538-7445.AM2023-CT005","article-title":"Abstract CT005: AEGEAN: A phase 3 trial of neoadjuvant durvalumab+ chemotherapy followed by adjuvant durvalumab in patients with resectable NSCLC","volume":"83","author":"Heymach","year":"2023","journal-title":"Cancer Res"},{"key":"B15","doi-asserted-by":"publisher","first-page":"425126","DOI":"10.1200\/JCO.2023.41.16_suppl.8501","article-title":"Perioperative toripalimab + platinum-doublet chemotherapy vs chemotherapy in resectable stage II\/III non-small cell lung cancer (NSCLC): Interim event-free survival (EFS) analysis of the phase III Neotorch study","volume":"41","author":"Lu","year":"2023","journal-title":"J Clin Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1080\/2162402X.2021.1996000","article-title":"Phase 2 trial of neoadjuvant toripalimab with chemotherapy for resectable stage III non-small-cell lung cancer","volume":"10","author":"Zhao","year":"2021","journal-title":"Oncoimmunology"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1716078","article-title":"Neoadjuvant PD-1 blockade in resectable lung cancer","volume":"378","author":"Forde","year":"2018","journal-title":"N Engl J Med"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(20)30453-8","article-title":"Neoadjuvant chemotherapy and nivolumab in resectable non-small-cell lung cancer (NADIM): an open-label, multicentre, single-arm, phase 2 trial","volume":"21","author":"Provencio","year":"2020","journal-title":"Lancet Oncol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2018.11.124","article-title":"Initial results of pulmonary resection after neoadjuvant nivolumab in patients with resectable non-small cell lung cancer","volume":"158","author":"Bott","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2017.09.030","article-title":"Surgical outcomes after neoadjuvant chemotherapy and ipilimumab for non-small cell lung cancer","volume":"105","author":"Yang","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1097\/jto.0000000000000074","article-title":"Incorporating immune-checkpoint inhibitors into systemic therapy of NSCLC","volume":"9","author":"Champiat","year":"2014","journal-title":"J Thorac Oncol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2023.1343504\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T23:29:46Z","timestamp":1703201386000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2023.1343504\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,22]]},"references-count":21,"alternative-id":["10.3389\/fimmu.2023.1343504"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2023.1343504","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,22]]},"article-number":"1343504"}}