A Brief Report on the Patterns of Mediastinal Nodal Failure in Resectable Stage IB-IIIA NSCLC Treated With Neoadjuvant Immunotherapy Combinations, a Secondary Analysis of a Prospective Trial

Within the last year, neoadjuvant nivolumab with platinum-doublet chemotherapy has been incorporated into national guidelines as the standard-of-care treatment for resectable NSCLC. As neoadjuvant ICI-based therapies become the induction standard for NSCLC, understanding of predictors for mediastinal nodal recurrence is exceedingly important as it may identify high risk patients who may benefit from additional adjunctive therapies. • This brief report is the first descriptive report of mediastinal nodal failure in patients with non-small-cell lung cancer who have received neoadjuvant immune checkpoint inhibitor-based therapy prior to definitive resection. Patients with mediastinal nodal recurrence have initial centrally located clinical stage IIIA disease. One patient with major pathologic response still developed mediastinal failure. • A large real-world study is needed to describe rates and risk-factor for mediastinal recurrence after neoadjuvant check-point inhibitor-based therapies that will help guide more personalized and precise recurrence modeling for high-risk patients.