408 Treatment patterns and clinical outcomes of patients with resectable NSCLC receiving neoadjuvant immunochemotherapy with or without adjuvant immunotherapy: a real-world single-center study

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Background Neoadjuvant or adjuvant chemotherapy confers a modest benefit over surgery alone for resectable non-small-cell lung cancer (NSCLC). Recently, novel neoadjuvant immunochemotherapy, with or without adjuvant therapy, became standard for resectable NSCLC, but real-world data remain limited. This study assessed real-world treatment patterns and outcomes in resectable stage II-III NSCLC patients who underwent neoadjuvant immunochemotherapy with or without adjuvant therapy in Korea.Methods This single-center retrospective study identified patients in the Electronic Medical Record from Nov 2022 to May 2025 with newly diagnosed stage II, IIIA, and IIIB (N2) NSCLC (AJCC 8th edition) treated with neoadjuvant immunochemotherapy, with or without adjuvant therapy. Baseline characteristics, treatment patterns, surgical outcomes, pathological complete response (pCR; 0% viable tumor in resected lung and lymph nodes), event-free survival (EFS), and overall survival (OS) were summarized.Results A total of 57 patients (stage II, n = 16; stage III, n = 41) met the eligibility criteria. The median age was 66 years. The majority of patients were male (n = 47), had squamous cell carcinoma (n = 32), and were PD-L1 negative (n = 28). Two patients had EGFR-sensitizing mutations, and three had ALK fusions. The median follow-up was 16.8 months. All patients received platinum-based neoadjuvant immunochemotherapy, with 22, 33, and 2 patients receiving 4, 3, and 2 cycles of neoadjuvant therapy, respectively. Of the total cohort, 45 patients underwent surgery, 4 are scheduled for surgery, and 8 were not eligible for surgery following the neoadjuvant phase. Among those who underwent surgery, a pCR was observed in 17 patients (38%), and adjuvant therapy was administered in 16 patients (36%). Seven patients experienced recurrence, and five patients expired. Due to the limited number of events, EFS and OS were not reached.Conclusions In patients with resectable NSCLC, neoadjuvant immunochemotherapy, with or without adjuvant therapy, demonstrated feasible outcomes in the real-world setting. Further follow-up is needed to assess the consistency of these outcomes compared to clinical trials and to establish the optimal treatment strategy from the initial stage of care.Consent Written informed consent was waivedEthics Approval National Cancer Center Korea IRB approved

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