ABSTRACT Objective Immunotherapy has emerged as a promising treatment for patients with pulmonary lymphoepithelioma carcinoma (PLEC). This study aimed to evaluate the efficacy and safety of neoadjuvant immunochemotherapy in patients with PLEC. Methods Clinical stage IB‐III patients with PLEC who underwent neoadjuvant immunochemotherapy followed by radical surgery were retrospectively collected from two centers. For comparative analysis, 83 lung squamous cell carcinoma (LUSC) and 82 lung adenocarcinoma (LUAD) patients receiving the same neoadjuvant regimen were retrospectively enrolled. Pathological response and survival outcomes were compared between PLEC and the other cohorts. To minimize selection bias and potential confounding factors, the data were analyzed using inverse probability of treatment weighting (IPTW). Results Among 40 patients with PLEC, 23 (57.5%) were female, with a mean age of 50.2 years. Major pathological response (MPR) was identified in 18 patients (45.0%) and pathological complete response (pCR) was achieved in 8 patients (20.0%). The median event‐free survival (EFS) was 24.8 months, with 1‐year and 2‐year EFS rates of 92.3% and 76.6%. Following IPTW adjustment, both pathological response and survival outcomes were comparable among the three cohorts. No statistically significant differences were observed between PLEC and LUSC patients in terms of MPR (45.0% vs. 66.3%, p = 0.306), pCR (20.0% vs. 47.0%, p = 0.228), or EFS (median: 24.8 vs. 28.5 months, p = 0.983). Similarly, PLEC demonstrated comparable MPR, pCR, and EFS to the LUAD cohort (MPR: 45.0% vs. 41.5%, p = 0.646; pCR: 20.0% vs. 25.6%, p = 0.978; median EFS: 24.8 vs. 22.5 months, p = 0.623). Conclusion Neoadjuvant immunochemotherapy demonstrates favorable efficacy and safety in patients with PLEC in this retrospective two‐center cohort. In adjusted analyses, EFS did not significantly differ from that observed in matched LUSC or LUAD patients, suggesting that this approach may be a reasonable option for selected PLEC patients.
Sun et al. (Fri,) studied this question.