The need for immunotherapy when neoadjuvant chemoradiotherapy achieves pathologic complete response in stage IIIB non-small cell lung cancer: a case report

The 5-year survival rate of patients with stage IIIB non-small cell lung cancer (NSCLC) range is 26%. Pathological complete response (pCR) is the best outcome after treatment for stage IIIB NSCLC. For patients with stage IIIB NSCLC, concurrent chemoradiotherapy with a curative intent is currently the standard treatment. For patients who respond to treatment, this is followed by consolidation immunotherapy with durvalumab. However, because of the complex and diverse nature of stage IIIB NSCLC, standard treatment is not necessarily suitable for all patients; rather, individualized and precise treatment can maximize the benefits of patients. Herein, we report a case of a patient with stage IIIB lung squamous cell carcinoma (SCC) treated with neoadjuvant chemoradiotherapy after receiving all 6 cycles of treatment, the patient underwent video-assisted thoracoscopic surgery (VATS) right upper lobectomy, right middle partial lobectomy, right lower partial lobectomy, and systematic mediastinal lymph node dissection. Postoperative pathological section results showed a pCR. The patient did not continue to use immunotherapy as a consolidation treatment after surgery. He remained disease free until the latest follow-up a half year later. This case has led us to doubt whether immunotherapy with durvalumab is still needed for patients with pCR. However, more clinical trials are needed to provide stronger evidence.