Neoadjuvant immunochemotherapy—a novel strategy for primary pulmonary lymphoepithelioma-like carcinoma

Abstract Objective: The objective of this study was to determine whether neoadjuvant immunochemotherapy impacted the subsequent surgical or pathological outcomes of patients with pulmonary lymphoepithelioma-like carcinoma (PLELC). Thisstudy was designed to evaluate the safety and efficacy of neoadjuvant immunochemotherapy in PLELC patients. Methods: A retrospective study was conducted on patients who received neoadjuvant immunochemotherapy in combination with chemotherapy followed by surgery between 2019 and 2022. The clinical records of the patients were analyzed. Results: Out of the 31 patients with PLELC who underwent neoadjuvant therapy followed by surgery, 18 patients (58.0%) experienced downstaging of the tumor. Nineteen patients (61.5%) achieved a partial response, 2 patients (6.4%) achieved a complete response,and 2 (6.4%) had progressive disease. Pathological evaluation of resected specimens revealed that 10 (32.3%) patients achieved major pathological response (MPR), including 2 (6.4%) who achieved complete response (CR). The mean disease-free survival (DFS) was 17.4 months, which was not significantly different from the value in LUSQ patients (15.1 months). Conclusion: Neoadjuvant immunochemotherapy resulted in downstaging of the tumor, thereby rendering it resectable, and did not significantly affect the safety and feasibility of surgery in this patient cohort.