Thoracic surgery clinics
-
Thoracic surgery clinics · May 2020
ReviewAdjuvant and Neoadjuvant Immunotherapy in Non-small Cell Lung Cancer.
The advent of immune checkpoint blockade has revolutionized the management of advanced non-small cell lung cancer (NSCLC). Impressive results in the metastatic setting have prompted substantial interest in the application of these agents in earlier-stage disease. ⋯ Resection specimens demonstrate encouraging rates of pathologic response. There are several ongoing phase 3 studies comparing neoadjuvant combination chemotherapy and checkpoint blockade to chemotherapy alone in patients with resectable NSCLC.
-
Five-year survival rates for patients with early-stage non-small cell lung cancer have room for improvement. Adjuvant chemotherapy results in a small but significant increase in overall survival at 5 years. Efforts to improve outcomes by intensifying adjuvant treatment, utilizing cancer-specific vaccines or tyrosine kinase inhibitors in unselected patients, have been unsuccessful. In addition to research with immune checkpoint inhibitors that are addressed in a separate article, ongoing studies to personalize adjuvant therapy either by selecting only patients with evidence of minimal residual disease or targeting tumor driver mutations are promising.