Top KOLs Discussing Neotorch
Neotorch Key Slides & Visuals
ESMO 2026 slides
| Toripalimab + chemo (n=250) | Placebo + chemo (n=251) | HR (95% CI), P | |
|---|---|---|---|
| Median EFS by investigator, months (95% CI) | NR (51.3–NE) | 20.2 (14.3–24.8) | 0.52 (0.391–0.677), P < 0.0001 |
| EFS rate by investigator at 24 / 36 months | 71.5% / 63.1% | 45.5% / 40.6% | — |
| Median EFS by IRC (secondary), months (95% CI) | NR (NE–NE) | 22.6 (15.1–45.8) | 0.53 (0.395–0.701), P < 0.0001 |
| EFS rate by IRC at 24 / 36 months | 70.1% / 64.0% | 48.4% / 44.5% | — |
| Toripalimab + chemo (n=250) | Placebo + chemo (n=251) | Difference (95% CI), P | |
|---|---|---|---|
| MPR (primary endpoint), % (95% CI) | 47.2 (40.9–53.6) | 9.2 (5.9–13.4) | 38% (31–45), P < 0.0001 |
| pCR (secondary endpoint), % (95% CI) | 25.6 (20.3–31.5) | 1.2 (0.2–3.5) | 24% (19–30), P < 0.0001 |
| Toripalimab + chemo (n=250) | Placebo + chemo (n=251) | HR (95% CI), P | |
|---|---|---|---|
| Deaths, n (%) | 73 (29.2) | 99 (39.4) | — |
| Median OS, months (95% CI) | NR (NE–NE) | NR (58.6–NE) | 0.66 (0.49–0.89), P = 0.0072 |
| OS rate at 24 / 36 months | 84% / 78% | 78% / 67% | — |
| PD-L1 (tumor cells) | Patients (toripalimab / placebo) | Median EFS, months | HR (95% CI) |
|---|---|---|---|
| <1% (n=129) | 63 / 66 | 51.3 vs 20.2 | 0.72 (0.436–1.191) |
| 1–49% (n=164) | 85 / 79 | 40.9 vs 15.4 | 0.41 (0.264–0.631) |
| ≥50% (n=157) | 75 / 82 | NR vs NR | 0.47 (0.262–0.812) |
| Toripalimab + chemo (n=202) | Placebo + chemo (n=202) | HR or difference (95% CI) | |
|---|---|---|---|
| EFS events / median EFS, months (95% CI) | 47 / NE (24.4–NE) | 97 / 15.1 (10.6–21.9) | HR 0.40 (0.277–0.565), two-sided P < 0.0001 (boundary 0.01683) |
| EFS rate at 1 / 2 years | 84.4% / 64.7% | 57.0% / 38.7% | — |
| pCR by BIPR, n (%) | 50 (24.8) | 2 (1.0) | 23.7 (17.6–29.8), nominal P < 0.0001 |
KOL-Made Infographics
Summary graphics designed or shared by physicians (not conference slides). Values are as the authors drew them. Click to enlarge.
@jryckman3Neotorch conversations on X
Posted in 2023 about the interim analysis (stage III patients, data cutoff November 30, 2022), an earlier data cut than the final analysis presented at ESMO 2026.
Physician reactions to Neotorch
#ESMO26 Dr. Shun Lu gives us the final analysis of the phase III Neotorch trial: perioperative toripalimab + chemotherapy for resectable stage II/III NSCLC. With 48.2m follow up, EFS 0.52 (median NR vs 20), MPR 47% vs 9%, pCR 26% vs 1%, OS HR 0.66. #ESMOAmbassadors https://t.co/4qsvyICFGa
🆙#ESMO26 Proffered Paper: #LCSM Non-Mets 🔥NEOTORCH: Toripalimab Plus Chemotherapy as Perioperative Treatment for Resectable Stage II or III Non-Small Cell Lung Cancer (NSCLC): Final Analysis of the Phase 3 Study 🎙️Dr. Shun Lu 🔢LBA64 🎯Significantly Improved EFS (NR vs 20.2mo, HR 0.52, p<0.0001; n=501) and OS (HR 0.66, p=0.0072) 🎯MPR 47.2% vs 9.2%, pCR 25.6% vs 1.2% ☑️NCT04158440 🔗 https://t.co/grEfaUchKN @OncoAlert @Larvol @myESMO @IASLC
🔥Neotorch Final Analysis: Perioperative toripalimab + chemo in resectable stage II/III NSCLC 🆙 @Annals_Oncology #ESMO26 🎙Dr. Ziming Li & Dr. Shun Lu 🎯Significantly Improved EFS (NR vs 20.2mo, HR 0.52, p<0.0001; n=501) and OS (HR 0.66, p=0.0072) 🎯MPR 47.2% vs 9.2%, pCR 25.6% vs 1.2% #LCSM @OncoAlert @Larvol https://t.co/7BSzito9TT
Improved EFS and OS w/ perioperative toripalimab in Neotorch (LBA64). 📌 Randomized, double-blind phase 3; final analysis (n=501 randomized), resectable stage II-III NSCLC. Toripalimab + platinum chemo vs placebo + platinum chemo perioperatively. 📌 Median follow-up 48.2 mo. mEFS NR vs 20.2 mo; HR 0.52 (95% CI 0.391-0.677). 📌 mOS NR in both arms; HR 0.66 (95% CI 0.486-0.894). 📌 Common AEs: neutropenia 58.0% vs 53.4%; decreased appetite 30.0% vs 15.1%. G≥3 AE rates aren't reported in the abstract. https://t.co/SCceCdT3GT #ESMO26 #LCSM
Posted on October 26, before the presentation, from the LBA64 abstract.
🆙 #ESMO26 Proffered Paper: #LCSM Non-Mets NSCLC, others 🔥NEOTORCH: Toripalimab Plus Chemotherapy as Perioperative Treatment for Resectable Stage II or III Non-Small Cell Lung Cancer 🎙️Dr. Shun Lu 🔢LBA64 🎯Final Analysis Met Primary Endpoints: EFS and MPR in Stage II-III Population ☑️NCT04158440 🔗 https://t.co/grEfaUbJVf @OncoAlert @Larvol @myESMO @IASLC
Posted on September 23, before the presentation.
Agree. My caution about having surgeons who don't meet quality criteria for st I-II NSCLC doing amateur hour surg for multistation N2 dzs applies to CM816, AEGEAN, NEOTORCH, KN-617, & NADIM2. This isn't broadly applicable strategy when you don't have same skill set as in study.
Posted in 2023 about the interim analysis (stage III patients, data cutoff November 30, 2022), an earlier data cut than the final analysis presented at ESMO 2026.
PeriOp/NeoAdj space in NSCLC post CM816, KN671, AEGEAN and NEOTORCH is obviously very exciting. But curious to see how these results play out in the real world given dramatically different surgical patterns in the community or rural settings (even when in controlled/clinical trial settings good amount of patients did not get to surgery). Great discussion by @JackWestMD here:
Posted in 2023 about the interim analysis (stage III patients, data cutoff November 30, 2022), an earlier data cut than the final analysis presented at ESMO 2026.
Important update. I am very interested in looking at other peri-operative trials’ (AEGEAN, NEOTORCH) long term outcomes. #ASCO23 #lungcancer #Immunotherapy
Posted in 2023 about the interim analysis (stage III patients, data cutoff November 30, 2022), an earlier data cut than the final analysis presented at ESMO 2026.
Neotorch Trial Design
Neotorch asked whether adding toripalimab, an anti-PD-1 antibody, to perioperative platinum-based chemotherapy and continuing it as maintenance after surgery improves outcomes in resectable stage II–III NSCLC. The trial is sponsored by Shanghai Junshi Biosciences. Final results were presented by Shun Lu, MD, at ESMO 2026 (LBA64, Proffered paper: Non-metastatic NSCLC and other thoracic malignancies, October 26, 2026), with Jordi Remon Masip, MD, as invited discussant, and published in Annals of Oncology the same day (first author Ziming Li, MD).
Study Design
Randomized 1:1, double-blind, placebo-controlled, multicenter phase 3 in China (NCT04158440; 55 hospitals); 250 vs 251 patients. Stratified by stage (II vs IIIA vs IIIB), lobectomy vs pneumonectomy, histology and PD-L1 (≥1% vs <1% or non-evaluable).
Population
Treatment-naive resectable stage II, IIIA or IIIB (N2) NSCLC; EGFR/ALK-altered nonsquamous tumors excluded; 404 stage III and 97 stage II patients. Median age 62; 454 men and 47 women.
Interventions
Toripalimab 240 mg or placebo Q3W plus platinum-based chemotherapy for 3 cycles before surgery and 1 cycle after surgery, then toripalimab or placebo monotherapy Q3W for up to 13 cycles.
Endpoints
Primary: EFS by investigator and MPR by BIPR, each in stage III and stage II–III. Secondary: OS, pCR, EFS by IRC, DFS, safety and feasibility of surgery.
Presenter & Discussant
Presenter and principal investigator: Shun Lu, MD (Shanghai Chest Hospital). Annals of Oncology first author: Ziming Li, MD. Invited discussant: Jordi Remon Masip, MD.
Data Cuts
Final analysis: data cutoff April 18, 2026; median follow-up 48.2 months; OS maturity 34.3%. Interim analysis (stage III only): data cutoff November 30, 2022; median follow-up 18.25 months.
Neotorch in the News
Neotorch Questions
What is the Neotorch trial?
Neotorch (NCT04158440) is a randomized, double-blind, placebo-controlled phase 3 trial sponsored by Shanghai Junshi Biosciences. It enrolled 501 patients with resectable stage II or III NSCLC at 55 hospitals in China and compared toripalimab or placebo, each with platinum-based chemotherapy for 3 cycles before and 1 cycle after surgery, followed by toripalimab or placebo maintenance for up to 13 cycles. EGFR- or ALK-altered nonsquamous tumors were excluded.
What did the Neotorch final analysis show at ESMO 2026?
At the final analysis (data cutoff April 18, 2026; median follow-up 48.2 months), investigator-assessed EFS in the stage II–III population was not reached vs 20.2 months, HR 0.52 (95% CI 0.391–0.677), P < 0.0001. Major pathological response by blinded independent review was 47.2% vs 9.2%. Both are primary endpoints in the stage II–III population and both were met at this analysis; MPR in stage III was also met, and stage III EFS had been met at the 2023 interim analysis. Results were presented by Shun Lu, MD (LBA64) and published in Annals of Oncology the same day.
Did toripalimab improve overall survival in Neotorch?
Overall survival is a secondary endpoint. At the final analysis there were 73 vs 99 deaths (34.3% maturity), medians were not reached in either arm, and the HR was 0.66 (95% CI 0.49–0.89), P = 0.0072. The LBA64 abstract and the Annals of Oncology paper describe the OS improvement as statistically significant. At the 2023 interim analysis (stage III only), the OS HR was 0.62 (0.38–1.00).
How do the final results differ from the 2023 interim analysis?
The interim analysis (data cutoff November 30, 2022; median follow-up 18.25 months) covered stage III patients only (404 patients) and reported EFS HR 0.40 (95% CI 0.277–0.565) and pCR by blinded review of 24.8% vs 1.0%, published in JAMA in 2024. The final analysis covers all 501 stage II and III patients with longer follow-up: EFS HR 0.52, pCR 25.6% vs 1.2%. The two analyses use different populations and data cuts and should not be compared directly.
Is perioperative toripalimab approved for lung cancer?
In China only. The NMPA approved toripalimab plus platinum doublet chemotherapy as perioperative treatment for resectable stage IIIA–IIIB NSCLC in December 2023, based on the interim analysis; Junshi said in May 2026 that it planned to submit a supplemental application to extend this to stage II–III. In the US, LOQTORZI (toripalimab-tpzi, Coherus) is FDA approved only for nasopharyngeal carcinoma, and in the EU Loqtorzi is approved only for nasopharyngeal carcinoma and esophageal squamous cell carcinoma. Perioperative toripalimab for NSCLC is investigational in the US and EU.
Who benefited by PD-L1 expression?
In exploratory subgroups, the EFS hazard ratio was 0.41 (0.264–0.631) for PD-L1 1–49% and 0.47 (0.262–0.812) for PD-L1 ≥50%. For PD-L1 <1% (129 patients) it was 0.72 (0.436–1.191), with a confidence interval that crosses 1. These subgroups were not powered for separate conclusions.