Tumor regression rate, PD-L1 expression, pembrolizumab/nab-paclitaxel–based regimens, squamous cell carcinoma, and comorbidities were independently associated with efficacy of neoadjuvant chemoimmunotherapy in non-small cell lung cancer

BackgroundNeoadjuvant chemoimmunotherapy (NCIO) is more effective than neoadjuvant immunotherapy alone for pathological response in non-small cell lung cancer (NSCLC) patients, but the processes for determining patient suitability for its implementation are not clear. We aimed to identify the most relevant factors and build a convenient model to select NSCLC patients who would benefit most from NCIO.Methods We retrospectively collected the clinical data of patients with locally advanced NSCLC who received NCIO followed by surgery at our institution between January 2019 and July 2022.ResultsA total of 101 eligible stage IIB-IIIC NSCLC patients were included. After NCIO, all patients successfully underwent surgical resection. A total of 46.53% (47/101) of patients achieved pathological complete response (pCR), and 70.30% (71/101) achieved major pathologic response (MPR). Tumor regression rate (adjusted odds ratio OR = 12.33), PD-L1 expression (adjusted odds ratio (OR) = 9.66), pembrolizumab/nab-paclitaxel–based regimens (adjusted OR = 4.92), and comorbidities (adjusted OR = 0.16) were independently associated with pCR rate (all P < 0.05). Tumor regression rate (adjusted OR = 8.45), PD-L1 expression (adjusted OR = 5.35), and presence of squamous cell carcinoma (adjusted OR = 7.02) were independently associated with MPR rate (all P < 0.05). We established and validated an easy-to-use clinical model to predict pCR (with an area under the curve [AUC] of 0.848) and MPR (with an AUC of 0.847). Of note, the present study showed that CD4+ T-cell count/rate and total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) levels in the peripheral blood of pre-NCIO patients were also significantly correlated with pathological response in univariate analyses.ConclusionsThe tumor regression rate, PD-L1 expression, pembrolizumab/nab-paclitaxel–based regimens, presence of squamous cell carcinoma, and comorbidities were the main influential factors for incidence of pCR/MPR in patients with stage IIB-IIIC NSCLC in the present study. Through predictive models, we can predict who will benefit most from NCIO prior to the emergence of clinical outcomes in locally advanced NSCLC

A BREZIS-NIRENBERG TYPE THEOREM ON LOCAL MINIMIZERS FOR p(x) -KIRCHHOFF DIRICHLET PROBLEMS AND APPLICATIONS

Abstract. This paper deals with a class of p(x) -Kirchhoff Dirichlet problems possessing a variational structure which corresponds to the variational functional E defined on W 1,p(x) 0 (Ω) . We prove a Brezis-Nirenberg type theorem which asserts that every local minimizer of E in the C 1 (Ω) topology is also a local minimizer of E in the W 1,p(x) 0 (Ω) topology. Some applications of this theorem are given

p(x)-Laplacian equations in RN with periodic data and nonperiodic perturbations

AbstractWe consider the p(x)-Laplacian equations in RN with periodic data and nonperiodic perturbations being stationary at infinity, where the perturbations are done not only for the coefficients but also for the exponents. Using concentration–compactness principle, under appropriate assumptions, we prove the existence of ground state solutions vanishing at infinity for the equations

A classification scheme for positive solutions of second order nonlinear iterative differential equations

This article presents a classification scheme for eventually-positive solutions of second-order nonlinear iterative differential equations, in terms of their asymptotic magnitudes. Necessary and sufficient conditions for the existence of solutions are also provided