A multicenter, single-arm, open study of neoadjuvant or conversion atezolizumab in combination with chemotherapy in resectable small cell lung cancer (Cohort Study) - Prospective Cohort Study

Sep 24, 2026

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Prospective multicenter, single-arm open study evaluating neoadjuvant or conversion atezolizumab plus etoposide/platinum chemotherapy before surgery in untreated limited-stage small cell lung cancer. Primary outcome was pathological complete response (pCR) in the per-protocol cohort, with safety characterized by treatment-related adverse events and postoperative complications. Among 13 surgical patients, pCR occurred in 61.5% (8/13) and major pathological response in 92.3% (12/13). Immune-related adverse events (grades 1–2) occurred in 17.6% and grade 3+ AEs were 58.8% (10/17).

LanguageEnglish

CategoryHealthcare

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Pages9

Reading Time23 min

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Background

Methods

Results

Efficacy outcomes

Safety and adverse events

Conclusion

Keywords

’Prospective Cohort Study A multicenter, single-arm, open study of neoadjuvant or conversion atezolizumab in combination with chemotherapy in resectable small cell lung cancer (Cohort Study) Hongtao Duan, MDa , Liang Shi, MDb , Changjian Shao, MDa , Yuanyong Wang, MDa , Zhaoyang Wang, MDa , Yunfeng Ni, MDa , Jinbo Zhao, MDa , Jianyong Sun, MDa , Liping Tong, MSca , Jie Lei, MDa , Tao Jiang, MDa,* , Zhe Liu, MDb,* , Xiaolong Yan, MDa,* Background: This study aimed to investigate the prospects of using chemotherapy in combination with atezolizumab in the neoadjuvant or conversion treatment of small cell lung cancer (SCLC) . Methods: Prior to surgery, untreated patients with limited-stage SCLC received three cycles of neoadjuvant or conversion atezolizumab combined with chemotherapy of etoposide and platinum. The primary endpoint of the trial was pathological complete response (pCR) in the per-protocol (PP) cohort. In addition, safety was assessed based on treatment-related adverse events (AEs) and postoperative complications. Results: Overall, 13 of 17 patients (including 14 males and 3 females) underwent surgery. In the PP cohort, pCR and major pathological response were observed in 8 (8/13, 61 .5%) and 12 (12/13, 92 .3%) patients, respectively. According to the intention-to-treat (ITT) analysis, the pCR and major pathological response in the ITT cohort were 47 . 1%(8/17) and 70 .6%(12/17), respectively. In addition, an overall response rate of 100% was recorded in the PP cohort. Moreover, 15 (15/17, 88 .2%) patients and 1 (1/17, 5 .9%) in the ITT cohort attained partial remission (PR), and complete remission, respectively, with an overall response rate of 94 . 1% . The median overall survival of the patients of pCR and the median event-free survival of the patients on surgery had not achieved. However, the median overall survival of the patients of non-pCR was 18 .2 months and the median event-free survival of the nonsurgical patients was 9 .5 months. During the neoadjuvant treatment, the incidence of grade 3 or higher AEs was 58.8%(10/17). Additionally, three patients (17.6%) developed immune-related adverse event (grades 1–2) . Conclusion: In patients with SCLC, neoadjuvant or conversion atezolizumab combined with chemotherapy signiﬁcantly improved pCR with manageable AEs. Therefore, this regimen may be considered a safe and effective treatment for SCLC. Keywords: atezolizumab, chemotherapy, neoadjuvant therapy, pCR, safety aDepartment of Thoracic Surgery at Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi and bDepartment of Oncology at Beijing Chest Hospital, Capital Medical University, Beijing, China H.D., L.S., C.S., and Y.W. contributed equally. They are joint ﬁrst authors. Sponsorships or competing interests that maybe relevant to content are disclosed atthe end of this article. *Corresponding authors. Address: Department of Oncology at Beijing Chest Hospital, Capital Medical University, 9 Beiguan Street, Tongzhou District, Beijing 101149, China. Tel.: +86 01 089 509 303. E-mail: [lza@vip.163.com](lza@vip.163.com) (Z. Liu); Department of Thoracic Surgery, Tangdu Hospital, Air Force Military Medical University, No.1, Xinsi Road, Xi’an, Shaanxi 710038, China. Tel.: +86 029 8477 8831. [E-mail: yanxiaolong@fmmu.edu.cn](E-mail: yanxiaolong@fmmu.edu.cn) (X. Yan), and Tel.: +86 02 98 471 7569. [E-mail: jiangtaochest@163.com](E-mail: jiangtaochest@163.com) (T. Jiang). Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons AttributionNoDerivatives License 4.0, which allows for redistribution, commercial and noncommercial, as long as it is passed along unchanged and in whole, with credit to the author. International Journal of Surgery (2023) 109:2641–2649 Received 20 February 2023; Accepted 10 May 2023 Supplemental Digital Content is available for this article. Direct URL citations are provided in the

FAQs

What is the purpose of this study in resectable small cell lung cancer?

To evaluate the prospects of using chemotherapy combined with atezolizumab as neoadjuvant or conversion treatment for small cell lung cancer prior to surgery.

How is the primary endpoint measured?

The primary endpoint is pathological complete response (pCR) assessed in the per-protocol (PP) cohort.

What safety outcomes were reported during neoadjuvant treatment?

Grade 3 or higher treatment-related adverse events occurred in 58.8% (10/17), and three patients (17.6%) developed immune-related adverse events of grades 1–2.

Sep 24, 2026

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