Revamping Non-Small Cell Lung Cancer Treatments in Stages II and III: Preparing Healthcare for Cutting-Edge Immuno-Oncology Regimens

Author:

Bertolaccini Luca1ORCID,Casiraghi Monica12ORCID,Bardoni Claudia1,Diotti Cristina1ORCID,Chiari Matteo1,Mazzella Antonio1ORCID,de Marinis Filippo3,Spaggiari Lorenzo12

Affiliation:

1. Department of Thoracic Surgery, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milan, Italy

2. Department of Thoracic Oncology, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy

3. Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy

Abstract

Non-small cell lung cancer (NSCLC) poses a significant challenge in clinical oncology, necessitating continual refinement of treatment approaches in stages II and III. Recent advancements have highlighted the potential of neoadjuvant therapy in optimising patient outcomes. Biomarker testing guides neoadjuvant therapy decisions, including epidermal growth factor receptor (EGFR) mutation and programmed death-ligand 1 (PD-L1) expression testing. Neoadjuvant therapy aims to improve oncological outcomes by treating micrometastatic disease and assessing tumour response before surgery. Disease-free survival is a surrogate endpoint for overall survival in both neoadjuvant and adjuvant settings. Multidisciplinary collaboration is crucial for individualised treatment planning and optimising patient care. The management of NSCLC requires a comprehensive approach, integrating expertise across disciplines and tailoring treatment strategies to individual patient needs. Neoadjuvant therapy shows promise in improving long-term outcomes, with biomarker testing guiding treatment decisions. Challenges such as defining borderline resectability and differentiating pseudoprogression highlight the need for ongoing research and collaboration.

Funder

Italian Ministry of Health with Ricerca Corrente

Publisher

MDPI AG

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