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Comment & Response
August 19, 2021

Immunochemotherapy as First-line Treatment for Locally Advanced or Metastatic Squamous Non–Small Cell Lung Cancers

Author Affiliations
  • 1Department of Thoracic Surgery, Guangdong Provincial People’s Hospital, Guangdong, Academy of Medical Sciences, Guangzhou, China
  • 2Shantou University Medical College, Shantou, China
  • 3The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
JAMA Oncol. 2021;7(10):1580. doi:10.1001/jamaoncol.2021.3372

To the Editor We read with great interest the article by Wang et al.1 The results from the RATIONALE 307 phase 3 randomized clinical trial strengthened the evidence for immunochemotherapy as first-line treatment for locally advanced or metastatic squamous non–small cell lung cancers.

We admired that this well-designed trial presented the efficacy and safety of tislelizumab plus chemotherapy in patients with treatment-naive advanced squamous non–small cell lung cancer. This study selected independent review committee–assessed progression-free survival (IRC-PFS) as the primary end point over overall survival, which not only enables quicker completion of trials but also prevents delays in subsequent standard treatment, as discussed by the authors.1,2 Moreover, the PFS was not confounded by subsequent therapy administered after progression. In the Methods section, the authors1 stated that patients in arm C could switch from chemotherapy to tislelizumab monotherapy if progressed disease was determined. Selection of IRC-PFS would be suitable to deal with the changes in treatment scheme. However, several issues are worthy of discussion and further investigations.

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