Immunochemotherapy combined with surgery in oligometastatic non-small cell lung cancer: a retrospective study

BACKGROUND The purpose of this trial was to assess the effectiveness of immunochemotherapy combined with surgery in patients with oligometastatic non-small cell lung cancer (NSCLC). METHODS We retrospectively reviewed 14 patients with oligometastatic NSCLC. Patients received 3–6 cycles of immunochemotherapy on day 1 of each 21-day cycle and underwent surgical resection of primary tumor. The metastatic lesions of 7 patients underwent surgery or radiotherapy. There were 9 cases of squamous cell carcinoma, 4 cases of adenocarcinoma, and 1 case of poorly differentiated lung cancer. Primary endpoint was pathologic complete response (pCR). Secondary endpoints included major pathological response (MPR), objective response rate (ORR), event-free survival (EFS), and overall survival (OS). RESULTS The pCR and MPR rates were 64% and 71% of all patients. In 4 patients with brain metastasis (BM), the pCR and MPR rate were 75% and 100%. The ORR was 100%. The median follow-up time was 21.8 months. The median EFS was 16.8 months, 12-month and 18-month EFS rate were 85.1% and 40.9% respectively, 12-month and 18-month OS rate were 92.3% and 83.1% respectively. In 4 patients with BM, the median EFS was 15.0 months, 12-month and 18-month EFS rate was 75% and 37.5% respectively, 12-month and 18-month OS rate was 100% and 100% respectively. CONCLUSIONS The treatment of immunochemotherapy combined with surgery significantly improved pathological response rate and ORR, prolonged EFS and OS in oligometastatic NSCLC.