Preoperative and Postoperative Systemic Therapy for Operable Non–Small-Cell Lung Cancer

Author:

Chaft Jamie E.1ORCID,Shyr Yu2ORCID,Sepesi Boris3ORCID,Forde Patrick M.4

Affiliation:

1. Thoracic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical Center, New York, NY

2. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN

3. Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX

4. Department of Medicine, Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD

Abstract

Cisplatin-based adjuvant chemotherapy remains the standard of care for patients with resected stage II or III non–small-cell lung cancer. However, biomarker-informed clinical trials are starting to push the management of early-stage lung cancer beyond cytotoxic chemotherapy. This review explores recent and ongoing studies focused on improving cytotoxic chemotherapy and incorporating targeted and immunotherapies in the management of early-stage, resectable lung cancer. Adjuvant osimertinib for patients with EGFR-mutant tumors, preoperative chemoimmunotherapy, and adjuvant immunotherapy could improve outcomes for selected patients with resectable lung cancer, and ongoing or planned studies leveraging biomarkers, immunotherapy, and targeted therapy may further improve survival. We also discuss the unique barriers associated with clinical trials of early-stage lung cancer and the need for innovative trial designs to overcome these challenges.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

Cancer Research,Oncology

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