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Vol.62 No.4 contents | Japanese/English |
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- Original Article -
Impact of Lymph Node Dissection on Programmed Death 1/Programmed Death Ligand 1 Inhibitor Therapy in Postoperative Recurrence of Non-small cell Lung Cancer
Akira Matsumoto1, Toshihiko Soma1, Tsuyoshi Shoji1, Hiromichi Katakura1, Kazuki Shima2, Tamaki Takahashi2, Michiyoshi Nishioka2, Naoki Sakai21Department of Thoracic Surgery, 2Department of Respiratory Medicine, Otsu Red Cross Hospital, Japan
Background. Immunotherapy is now widely used in the treatment of non-small cell lung cancer (NSCLC). In the cancer immune response, priming of T lymphocytes in the draining lymph nodes is considered necessary. In this context, the effect of programmed death 1/programmed death ligand 1 (PD-1/PD-L1) inhibitors may be weakened after lymph node dissection. We therefore evaluated the differences in the clinical response to PD-1/PD-L1 inhibitors in NSCLC patients with and without lymph node dissection. Methods. We conducted a retrospective study of NSCLC patients treated with PD-1/PD-L1 inhibitors at Otsu Red Cross Hospital by November 2020. Results. There were 25 cases of lymph node dissection and 63 unresectable cases. The disease control rates in the groups with and without resection were 10 (40%) and 16 (25%), the overall response rate was 6 (24%) and 6 (9%), the median overall survival was 19.5 and 10.5 months (P=0.47), and the median progression-free survival was 8.3 and 5.6 months (P=0.86), respectively. There were 4 (16%) and 7 (11%) (P=0.5) grade ≥3 immune-related adverse events in the groups with and without resection, respectively. Conclusion. In patients with recurrent disease after curative resection who underwent lymph node dissection for NSCLC, the therapeutic effect of PD-1/PD-L1 inhibitors was not inferior to that of unresectable cases, both in terms of the therapeutic effect and the risk of adverse events.
key words: Non-small cell lung cancer, Lymph node dissection, Immune-checkpoint inhibitor
Received: December 13, 2021
Accepted: May 2, 2022
JJLC 62 (4): 304-310, 2022
