2351 - Efficacy and Safety of Oral Chemotherapy Concurrent Radiotherapy in Patients with Unresectable Stage III Non-Small Cell Lung Cancer after Neoadjuvant Chemoimmunotherapy
Presenter(s)
L. Deng; National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, China
Purpose/Objective(s): The objective of this study was to assess the effectiveness and safety of oral vinorelbine combined with concurrent radiotherapy in patients with unresectable stage III NSCLC after neoadjuvant immunotherapy, aiming to establish an efficacious treatment regimen for these patients.
Materials/Methods: This was a single-arm, phase 2 trial, with the objective response rate (ORR) as the primary endpoint. Treatment compliance, the safety profile, progression-free survival, and the disease control rate comprised the secondary endpoints.
Results: Between March 10, 2023, and January 18, 2025, 46 patients with unresectable stage III NSCLC received oral vinorelbine concurrently with thoracic radiotherapy. Patients were treated with oral vinorelbine 60 mg/m2 once a week for 2 weeks as induction therapy before thoracic radiotherapy and 30 mg/m2 per week with radiotherapy (59.4–60.2Gy) over 5.5 weeks. The patients had a median age of 62.5 years, and 42 were male (91.3%). In the efficacy analyses, the ORR was 52.1% (95% confidence interval (CI): 35.1–65.9%), with 24 partial responses. We observed a 95.7% disease control rate (85.5–98.8%), including two patients with stable disease. With a median follow up of 18.4 months, median progression-free survival was not reached. In the safety analyses, the most frequently reported adverse events were leukopenia (grade 1, 26.1%), anemia (grade 1, 17.4%), neutropenia (grade 1, 10.9%), acute esophagitis (grade 2, 17.4%), and radiation pneumonitis (grade 2, 60.9%). No treatment-related adverse events of grades 3 to 4 was recorded.
Conclusion: In patients with unresectable stage III non-small cell lung cancer who had received neoadjuvant chemoimmunotherapy and were not candidates for concurrent intravenous chemotherapy with radiotherapy, the combination of oral vinorelbine and concurrent radiotherapy demonstrated promising antitumor efficacy with acceptable toxicity profiles.