非小细胞肺癌（NSCLC）是肺癌最常见的类型，尽管如此，支持某些阶段最佳管理方案的证据仍然是一个争议话题。在这项回顾性研究中，我们检查了新辅助诱导免疫化疗的疗效和安全性，并探讨了这种治疗方式在中国不可手术的III期NSCLC患者中的生物标志物。从2019年1月17日至2022年1月17日，从三家中国医院中筛选出经鉴定为驱动突变阴性并接受新辅助化疗免疫治疗的不可手术III期NSCLC患者。收集了围手术期结果和生存数据。在可用的基线肿瘤样本和手术标本中进行回顾性生物标志物探索。共有94名患者接受了以化疗免疫疗法为新辅助治疗方案的治疗。其中80名患有鳞状细胞癌，26名为IIIB期病。手术转化率为74.4％，R0切除率为98.4％。在接受手术的64名患者中，主要病理学反应（MPR）率为65.6％，病理学完全缓解（pCR）率为42.2％。73％的N2疾病患者出现N0的下分化。治疗相关的不良事件（TRAEs）发生在43名患者中（45.7％），贫血最为常见。 ≥3级TRAEs率为3.2％（3/94）。还发现了拷贝数变异（CNV）倍性与MPR的显著关联。免疫化疗联合治疗不可手术的III期NSCLC不仅有效而且安全性良好。我们首次提供了CNV状况可能是MPR预测生物标志物的证据。 版权所有©2023 Elsevier B.V.。保留所有权利。

Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. Despite this, evidence supporting optimal management of certain stages remains a topic of debate. In this retrospective study we examine the efficacy and safety, as well as exploring the biomarkers of neoadjuvant induction immuno-chemotherapy, in Chinese patients with unresectable stage III NSCLC.Patients with unresectable stage III NSCLC who were identified as driver mutation-negative and who received neoadjuvant chemo-immunotherapy were enrolled from three Chinese hospitals between Jan. 17, 2019, and Jan.17, 2022. Perioperative outcomes and survival data were collected. Retrospective biomarker exploration was performed in available baseline tumor samples and surgical specimens.94 patients were enrolled and received chemo-immunotherapy as neoadjuvant treatment. 80 patients had squamous cell carcinoma, and 26 had stage IIIB disease. Surgery conversion rate was 74.4%, R0 resection rate was 98.4%. Of 64 patients who underwent surgery, major pathological response (MPR) rate was 65.6% and pathologic complete response (pCR) rate was 42.2%. 73% of patients with N2 disease demonstrated down-staging to N0. Treatment-related adverse events (TRAEs) occurred in 43 patients (45.7%) with anemia was the most common. The Grade ≥ 3 TRAEs rate was 3.2% (3/94). A significant association between copy number variation (CNV) ploidy was also found.The combination treatment of immuno-chemotherapy for unresectable stage III NSCLC is not only effective but also has a favourable safety profile. For the first time we provide evidence that CNV status may be a predictive biomarker of MPR.Copyright © 2023 Elsevier B.V. All rights reserved.