ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1637615
Neoadjuvant Immunotherapy Plus Chemotherapy for Resectable Non-Small Cell Lung Cancer with Driver Mutations: A Retrospective Analysis
Provisionally accepted
- 1Affiliated Cancer Hospital of Shandong First Medical University Department of Radiation Oncology, Jinan, China
- 2Harbin Medical University Cancer Hospital, Harbin, China
- 3Lianyungang No 1 People's Hospital, Lianyungang, China
- 4West China Hospital of Sichuan University, Chengdu, China
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Background: Neoadjuvant immunotherapy combined with chemotherapy offers significant benefits for patients with resectable non-small cell lung cancer (NSCLC). However, its efficacy and safety in patients harboring driver gene mutations remain unclear. This study aimed to assess the real-world efficacy and safety of neoadjuvant immunotherapy plus chemotherapy in resectable NSCLC with and without driver gene mutations. Methods: We retrospectively analyzed patients with NSCLC who received neoadjuvant immunotherapy plus chemotherapy followed by surgical resection. Efficacy was evaluated based on the best radiological response, major pathological response, and pathological complete response. Survival outcomes were assessed using event-free survival, and safety was evaluated in all patients. Results: The study included 73 patients, comprising 34 with driver gene mutations and 39 without driver gene mutations. During the neoadjuvant therapy phase, the best radiological response rate was 58.8% in the mutated group and 66.7% in the wild-type group (p = 0.489). The major pathological response rate was 47.1% in the mutated group and 41.0% in the wild-type group (p = 0.604). The pathological complete response rates were 32.4% and 33.3%, respectively (p = 0.929). No significant differences were observed in event-free survival between the mutated and wild-type groups (p = 0.83). Grade 3 treatment-related adverse events occurred in 11.8% of patients with driver gene mutations and 17.9% of patients without driver gene mutations; no Grade 4 or 5 adverse events were reported. Conclusion: Neoadjuvant immunotherapy plus chemotherapy remains a promising treatment option for patients with resectable NSCLC, irrespective of genetic mutation status.
Keywords: Driver gene mutation, immune checkpoint inhibitors, Immunotherapy, Neoadjuvant, Non-small cell lung cancer
Received: 29 May 2025; Accepted: 05 Aug 2025.
Copyright: © 2025 Xu, Yao, Geng, Huang, Zou, Sun, Yu and TENG. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: FEIFEI TENG, Affiliated Cancer Hospital of Shandong First Medical University Department of Radiation Oncology, Jinan, China
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