Monitoring methods for the efficacy of neoadjuvant immunotherapy in locally advanced resectable non-small cell lung cancer
Objective To present a rough idea of current monitoring methods for neoadjuvant immunotherapy in locally ad-vanced non-small cell lung cancer(NSCLC)from the perspectives of imaging and biomarkers based on available studies for timely evaluation of efficacy and control of treatment strategies.Methods A literature search was conducted on PubMed and CNKI using keywords"neoadjuvant immunotherapy,imaging,biomarker,pseudo-progression,and locally advanced resectable non-small cell lung cancer"from January 2009 to February 2024.Inclusion criteria:(1)Standard therapy for lo-cally advanced NSCLC;(2)Neoadjuvant immunotherapy for locally advanced NSCLC;(3)Means of monitoring the effica-cy of neoadjuvant immunotherapy and its significance;(4)Relative research on imaging and biomarkers for evaluating the efficacy of neoadjuvant immunotherapy.Exclusion criteria:(1)Conference abstracts,dissertation and other informal es-says;(2)Studies with weak relevance to the keywords;(3)Literature with unresolved controversies or unclear mecha-nisms.A total of 49 literatures were included(7 in Chinese and 42 in English).Results Neoadjuvant immunotherapy shows potential in inducing tumor regression and increasing the probability of complete surgical resection in patients with locally advanced NSCLC.However,it faces challenges in practical application.Compared to traditional imaging evalua-tion criteria response evaluation criteria in solid tumors(RECIST),new imaging evaluation criteria such as immune-related response criteria(irRC),immune-related RECIST(irRECIST),and immune RECIST(iRECIST)demonstrate a better as-sessment of the efficacy.Biomarkers such as circulating tumor DNA(ctDNA)offer a simpler and more comprehensive al-ternative than tissue biopsy.Conclusions For neoadjuvant immunotherapy in locally advanced NSCLC,the relatively more accurate new imaging criteria still have some limitations and require further evaluation and refinement.While bio-markers such as ctDNA hold great potential,their detection techniques are demanding and require further standardization.
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