Clinical Outcomes of Neoadjuvant Chemoimmunotherapy vs. Chemoradiotherapy in Operable Non-Small Cell Lung Cancer

Introduction Non-small cell lung cancer (NSCLC) accounts for ~85% of lung cancers and remains the leading cause of cancer death. Surgery is curative for early-stage disease, but recurrence rates remain high. CheckMate-816 trial established neoadjuvant chemo-immunotherapy (chemo-IO) as a new standard for resectable NSCLC, demonstrating improved pathologic response and event-free survival. PACIFIC trial showed the survival benefit of consolidative immunotherapy after chemoradiotherapy (chemo-RT) in unresectable stage III NSCLC, highlighting the synergy between radiation and immune checkpoint blockade. Despite these advances, there is little comparative data on the role of chemo-IO versus chemo-RT in the neoadjuvant, operable setting. Objective: To compare clinical outcomes between patients treated with neoadjuvant chemo-IO and those treated with chemo-RT prior to surgery at a single institution.