Immunotherapy Before Surgery Enhances Long-Term Survival in Lung Cancer Patients: Findings from a Global Clinical Trial

A recent landmark Phase III clinical trial has demonstrated that administering immunotherapy prior to surgical removal significantly improves long-term survival outcomes for lung cancer patients. The study, published in the New England Journal of Medicine, focused on patients with non-small cell lung cancer (NSCLC), the most common type of lung cancer, staged where tumors are candidates for surgery.

The trial revealed that patients who received nivolumab, an immune checkpoint inhibitor, along with standard chemotherapy before their surgery, exhibited about a 10% higher likelihood of survival at five years compared to those treated with chemotherapy alone. Notably, among the patients who achieved no remaining detectable cancer at surgery, none had died from lung cancer within the five-year follow-up period.

This breakthrough was presented by Prof. Patrick Forde from Trinity St. James's Cancer Institute at the American Society of Clinical Oncology Annual Meeting in Chicago. The trial involved 358 participants globally, emphasizing the benefit of integrating immunotherapy into early-stage lung cancer treatment. Historically, over half of the patients with stage 2 or 3 lung cancer who undergo surgery experience relapse, underscoring the significance of these findings.

Immunotherapy drugs such as nivolumab work by blocking PD-1 receptors, thereby unmasking the tumor to the patient’s immune system and enhancing the body's ability to attack cancer cells. Before this trial, immunotherapy's success had been primarily observed in advanced lung cancers, and evidence for its long-term benefits in early-stage disease was limited.

Earlier research by Prof. Forde at Johns Hopkins in 2018 identified promising results, with nearly half of the patients showing minimal or no residual cancer after two doses of immunotherapy before surgery. The current data further reinforces the potential of neoadjuvant therapy—treatment given before surgery—to improve complete tumor eradication and reduce relapse rates, without increasing side effects.

These promising results have led to the approval of nivolumab combined with chemotherapy as a standard pre-surgical treatment in several countries, including Ireland. The latest update shows these patients are approximately 10% more likely to survive five years post-treatment. Importantly, patients who achieved a complete pathological response, meaning no cancer remaining at surgery, had no lung cancer-related deaths within five years.

Prof. Forde is also leading additional international trials, aiming to enhance outcomes further with new treatment combinations. Overall, these advances mark a significant step forward in the fight against lung cancer, offering hope for improved cure rates through early, targeted immunotherapy interventions.

Source: https://medicalxpress.com/news/2025-06-immunotherapy-surgery-lung-cancer-survival.html