• The lancet oncology · Nov 2021

    Review

    Revisiting neoadjuvant therapy in non-small-cell lung cancer.

    • Stephanie P L Saw, Boon-Hean Ong, Kevin L M Chua, Angela Takano, and TanDaniel S WDSWDivision of Medical Oncology, National Cancer Centre Singapore, SingHealth Duke-NUS Oncology Academic Clinical Programme, Singapore; Genome Institue of Singapore A*Star, Singapore. Electronic address: daniel.tan.s.w@singhealth.com.sg..
    • Division of Medical Oncology, National Cancer Centre Singapore, SingHealth Duke-NUS Oncology Academic Clinical Programme, Singapore.
    • Lancet Oncol. 2021 Nov 1; 22 (11): e501-e516.

    AbstractDespite the rapidly evolving treatment landscape in advanced non-small-cell lung cancer (NSCLC), developments in neoadjuvant and adjuvant treatments have been nascent by comparison. Establishing overall survival benefit in the early-stage setting has been challenging because of the need for large trials and long-term survival data. Encouraged by improved treatment outcomes with a biomarker-driven approach in advanced NSCLC, and recognising the need to improve survival outcomes in early-stage NSCLC, there has been renewed interest in revisiting neoadjuvant strategies. Multiple neoadjuvant trials with targeted therapy and immunotherapy, either alone or in combination with chemotherapy, have yielded unique insights into traditional response parameters, such as the discordance between RECIST response and pathological response, and expanded opportunities for biomarker discovery. With further standardisation of trial endpoints across studies, coupled with the implementation of novel technologies including radiomics and digital pathology, individual risk-stratified neoadjuvant treatment approaches are poised to make a striking impact on the outcomes of early-stage NSCLC.Copyright © 2021 Elsevier Ltd. All rights reserved.

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