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Adjuvant and neo-adjuvant therapy for non-small cell lung cancer without EGFR mutations or ALK rearrangements

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Abstract

Surgical resection is the most effective therapeutic option for the cure in early stage resectable non-small-cell lung cancer (NSCLC). However, despite complete resection, up to 70% of patients die within 5 years mainly due to tumor recurrence in extra-thoracic organs. Adjuvant or neoadjuvant platinum-based chemotherapy may improve postoperative survival, but the absolute survival benefit is modest with an around 5% improvement at 5 years. Recent advance in systemic therapy has changed treatment strategy for advanced unresectable NSCLC, and also has provided a paradigm shift in treatment strategy for resectable NSCLC. For NSCLC without oncogenic driver alterations, immunotherapy using immune-checkpoint inhibitors may improve clinical outcomes in preoperative neoadjuvant setting as well as in postoperative adjuvant setting. Here, we overview recent evidence of adjuvant and neoadjuvant therapy and discuss emerging clinical questions in decision-making of treatment for potentially resectable patients with NSCLC harboring no oncogenic alterations.

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  1. Masaru Takenaka and Koji Kuroda have contributed equally to the article.

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  1. Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Iseigaoka 1-1, Yahata-Nishi-Ku, Kitakyushu, 8078555, Japan

    Masaru Takenaka, Koji Kuroda & Fumihiro Tanaka

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  1. Masaru Takenaka
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Correspondence to Fumihiro Tanaka.

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Fumihiro Tanaka has received lecture fees from MSD, Bristol-Meyers Squibb, Boehringer Ingelhaim, Ono, Johonson & Johonson, Medtronic, Taiho, Eli Lilly, Astra Zeneca, Daiichi-Sankyo and Chugai, and has received research grants from MSD, Bristol-Meyers Squibb, Ono, Boehringer Ingelhaim, Eli Lilly, Astra Zeneca, Chugai, Amgen and Abbvie. Masaru Takenaka and Koji Kuroda reports no conflicts of interest.

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Takenaka, M., Kuroda, K. & Tanaka, F. Adjuvant and neo-adjuvant therapy for non-small cell lung cancer without EGFR mutations or ALK rearrangements. Int J Clin Oncol (2024). https://doi.org/10.1007/s10147-023-02459-y

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