RATIONALE-315: Post hoc analysis of event-free survival by surgically relevant subgroups treated with perioperative tislelizumab and neoadjuvant chemotherapy vs neoadjuvant chemotherapy

ASCO 2026NSCLCTislelizumabPoster

Gustavo Schvartsman, MD, PhD

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SUMMARY

This post hoc analysis of the Phase 3 RATIONALE315 trial evaluated the association between eventfree survival (EFS) and surgical outcomes in patients with resectable stage II–IIIA nonsmall cell lung cancer treated with perioperative tislelizumab or placebo plus neoadjuvant chemotherapy. A total of 453 patients were randomized 1:1, and as of March 7, 2025, definitive surgery was performed in 190/226 patients in the tislelizumab arm and 173/227 patients in the placebo arm. An EFS benefit with tislelizumab versus placebo was observed across surgically relevant subgroups (hazard ratio, 0.62; 95% CI, 0.44–0.88). Although R0 resection rates were similar between treatment arms, EFS favored tislelizumab over placebo in patients achieving R0 resection (hazard ratio, 0.62; 95% CI, 0.43–0.90), with a similar trend observed in patients with R1/R2 resections, noting limited patient numbers. Among patients undergoing minimally invasive and open surgery, respectively, Grade ≥3 treatmentemergent adverse events occurred in 77.2% and 78.8% of patients in the tislelizumab arm and 71.3% and 81.7% of patients in the placebo arm.

 
ClinicalTrials.gov ID: NCT04379635

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