# Neoadjuvant nivolumab plus chemotherapy followed by resection for superior sulcus tumour with high PD‐L1 expression: A case report

## TL;DR

A 76-year-old man with a lung tumor near the shoulder had successful treatment using immunotherapy plus chemotherapy before surgery, leading to complete removal of the tumor.

## Contribution

This case report presents a new treatment approach for superior sulcus tumors using neoadjuvant chemo-immunotherapy followed by minimally invasive surgery.

## Key findings

- Neoadjuvant nivolumab plus chemotherapy led to a pathologic complete response in a superior sulcus tumor.
- The tumor was successfully resected with minimal invasion through a modified thoracotomy.
- No residual tumor cells were found in the resected specimen.

## Abstract

The standard treatment for resectable non‐small cell lung cancer (NSCLC) located in the superior sulcus is neoadjuvant chemoradiotherapy followed by highly invasive resection. Based on the results of the CheckMate 816 trial, which showed a marked improvement in the efficacy of neoadjuvant chemo‐immunotherapy, we report a case of minimally invasive resection after neoadjuvant nivolumab plus chemotherapy for superior sulcus NSCLC, resulting in a pathologic complete response. The patient was a 76‐year‐old man with a 65‐mm right superior sulcus tumour diagnosed as squamous cell carcinoma with 95% PD‐L1. After two courses of neoadjuvant nivolumab plus chemotherapy, the tumour was completely resected through an 11‐cm right lateral thoracotomy with second rib resection and first rib preservation. No residual tumour cells were observed in the specimen, and the patient had a pathologic complete response. This report represents a new treatment option for superior sulcus tumours.

Neoadjuvant nivolumab plus chemotherapy followed by resection for superior sulcus tumour with high PD‐L1.