术前应用靶向药物治疗ALK阳性NSCLC患者的围手术期安全性分析OA

Background and objective Perioperative management of locally advanced non-small cell lung cancer(NSCLC)remains a significant clinical challenge.Although anaplastic lymphoma kinase-tyrosine kinase inhibitors(ALK-TKIs)have established a definitive role in the adjuvant setting for ALK-positive NSCLC,clinical evidence supporting their preopera-tive application remains scarce.Recent exploratory trials,such as the ALNEO study,indicated that preoperative ALK-TKIs therapy can achieve favorable major pathological response(MPR)rates;however,documented data regarding its perioperative safety remain limited.This study aims to evaluate the perioperative safety and feasibility of preoperative ALK-TKIs therapy through a retrospective,single-center analysis.Methods A retrospective review was conducted using the data of ALK-positive NSCLC patients recorded in the prospective database of Department I of Thoracic Surgery at Peking University Cancer Hospi-tal from 2021 to 2024,who underwent surgical resection following preoperative ALK-TKIs therapy.Short-term efficacy,surgi-cal outcomes,perioperative complications,and long-term survival data were systematically evaluated.Results Eleven patients were included,predominantly consisting of female non-smokers(9/11),and the pathological type for all patients was adeno-carcinoma.Baseline clinical staging included stage IIIA(n=7),stage IIIB(n=3),and stage IV with oligometastasis(n=1).All patients received preoperative ALK-TKIs,with 4 receiving concurrent chemotherapy.The objective response rate(ORR)was 81.8%.All patients successfully underwent surgery via video-or robotic-assisted thoracoscopic surgery.The mean operative time was(122.0±62.3)min and the median intraoperative blood loss was 74.0 mL(range:5.0-300.0 mL).The MPR and patho-logical complete response(pCR)rates were 45.5%(5/11)and 27.3%(3/11),respectively.All patients received postoperative adjuvant therapy,primarily targeted drugs.At a median follow-up of 30 months,no deaths occurred in the entire cohort;how-ever,three patients experienced disease recurrence(one with intestinal and liver metastases,and two with brain metastases).Conclusion Preoperative ALK-TKIs therapy demonstrates favorable safety and feasibility in this small-sample cohort of ALK-positive NSCLC patients.