Chemotherapy plus immuno therapy as neoadjuvant treatment in non-small cell lung cancer NSCLC: case report of a long-term survivor with borderline disease for resectability at diagnosis. Quimioterapia más inmunoterapia como tratamiento neoadyuvante en el cáncer de pulmón de células no pequeñas CPCNP: caso clínico de un superviviente con enfermedad limítrofe para resecabilidad al diagnóstico

Abstract

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related mortality worldwide. The mainstay of curative treatment is complete surgical resection; however, approximately 70% of the patients have advanced or locally advanced unresectable disease at the time of diagnosis. Historically, the standard of care in the early setting has been the administration of 3 to 4 cycles of cisplatin-based chemotherapy before or after surgery. This approach has demonstrated a 5-year survival benefit of approximately 5%. More recently, given the positive results in the metastatic setting, the utility of the immunotherapy regimen of checkpoint inhibitors plus chemotherapy (IQt) as neoadjuvant treatment of potentially resectable NSCLC has been investigated. Scientific evidence has shown that this intervention significantly increases response rates and survival, which has supported the approval of this indication by regulatory agencies and its inclusion in treatment guidelines.  Clinical case: A clinical case with a long follow-up is described below as an illustrative example of the approach of a patient with NSCLC with a tumor with borderline criteria for resectability who showed a very good response to treatment with the new neoadjuvant IQt regimen and also highlights the importance of approaching and evaluating patients with locally advanced NSCLC in the context of a multidisciplinary oncology team. Conclusion: this therapeutic approach presents a predictable and manageable safety profile that does not generate delays in surgical treatment and has a positive impact on overall survival.