[Lung Cancer Advanced Treatment] Neoadjuvant Immunotherapy: What the NEOTORCH Trial Reported on Toripalimab (Not Yet Approved in Japan)

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This article is a summary of international medical information and is not medical advice; it cannot replace the diagnosis or treatment plan of your attending physician. The medical technologies, drug information and clinical data presented here are compiled from public literature and official statements of Japanese medical institutions; the applicability and outcome of any therapy vary with each patient and must be assessed individually by a qualified physician.

Any specific treatment plan must be assessed by a licensed physician in Japan

For Stage III non-small cell lung cancer (NSCLC) patients, surgery alone often fails to achieve curative goals. A study presented at ASCO 2023 — the NEOTORCH trial — examined preoperative toripalimab plus chemotherapy for this stage. The results below are published study data; efficacy and safety have not been established in Japan.

I. NEOTORCH Trial: Reported Data

This randomized, double-blind trial enrolled 404 resectable Stage III patients, evaluating "toripalimab + chemotherapy" versus "placebo + chemotherapy."

Key Clinical Endpoints:

Event-Free Survival (EFS): Median EFS had not been reached in the combination arm at the time of analysis, compared with 15.1 months in the placebo arm.
Major Pathological Response (MPR): 48.5% in the combination arm and 8.4% in the placebo arm.
Pathological Complete Response (pCR): 24.8% in the combination arm and 1.0% in the control arm.

II. Safety and Surgical Tolerability

Safety analysis showed that adding toripalimab did not significantly increase the incidence of serious adverse events, and the majority of patients were able to complete surgery as planned. Side effects and suitability should be discussed with the treating physician.

III. Why Is Neoadjuvant Immunotherapy Increasingly Important in Lung Cancer?

Neoadjuvant therapy is studied with the aim of treating micrometastatic disease before surgery. Whether perioperative treatment is appropriate depends on each patient's imaging and pathological findings and must be decided by the treating physician.

※ The drug Toripalimab mentioned in this article is currently not approved in Japan. This content is only a summary of published research. To learn about the options that can be considered now, we suggest talking first with your attending physician.

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