{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:04:17Z","timestamp":1790229857260,"version":"4.1.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"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>Previous evidence demonstrated that neoadjuvant chemo-immunotherapy provides significant prognostic benefits for non-small cell lung cancer (NSCLC). While the efficacy of serplulimab, an anti-PD-1 monoclonal antibody, has been well established in advanced driver gene-negative NSCLC in the ASTRUM-004 trial, its efficacy in the neoadjuvant setting remains unclear. This real-world study aims to evaluate the efficacy and safety of neoadjuvant serplulimab plus chemotherapy in patients with locally advanced squamous NSCLC, with a particular focus on pathological response outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a multicenter, retrospective\u2013prospective, real-world observational study. Electronic medical records were retrospectively reviewed to identify eligible patients with locally advanced squamous NSCLC who received at least 1 cycle of neoadjuvant serplulimab (300\u00a0mg, Q3W) combined with platinum\u2013taxane chemotherapy. Prospective follow-up was conducted to complete courses and outcomes. The primary endpoint was major pathologic response (MPR), and the secondary endpoints included pathological complete response (pCR), objective response rate (ORR), event-free survival (EFS), overall survival (OS), and safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty patients were included (median age 64 years; 96.7% male; 86.7% stage III). Most patients received two cycles of neoadjuvant therapy (46.67%), and 80% achieved a radiologic ORR (95% CI, 61.4\u201392.3%). Surgery was performed on 28 patients (93.33%), with MPR and pCR achieved in 57.1% (95% CI, 39.1\u201373.5%) and 28.6% (95% CI, 15.3\u201347.1%), respectively, and an R0 resection rate of 92.9%. Compared with the historical chemotherapy group, the observed MPR was significantly higher (57.1% vs 8.9% and 11.0%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001). The median EFS reached 29.97 months, and the 12-month EFS rate was 91.8% (95% CI, 81.4\u2013100%). The OS data were immature. Grade 3 adverse events occurred in 6.7% of patients, and no grade 4\u20135 events or perioperative immune-related complications were reported. Exploratory analyses revealed that a lower post-treatment neutrophil-to-lymphocyte ratio (NLR&amp;lt; 3) was positively correlated with MPR, whereas advanced T stage (T3\u2013T4) was negatively associated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Neoadjuvant serplulimab-chemotherapy demonstrated promising efficacy and manageable toxicity in real-world locally advanced NSCLC. Survival outcomes require longer follow-up to assess clinical benefit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1882282","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:43:30Z","timestamp":1790228610000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Neoadjuvant serplulimab combined with chemotherapy in locally advanced driver gene-negative squamous NSCLC: a multicenter observational study"],"prefix":"10.3389","volume":"17","author":[{"given":"Nanlong","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, First Affiliated Hospital of Fujian Medical University","place":["Fuzhou, China"]},{"name":"Department of Thoracic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University","place":["Fuzhou, 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