Details

Autor(en) / Beteiligte

• Aguado, Carlos
• Chara, Luis
• Antoñanzas, Mónica
• Matilla Gonzalez, Jose Maria
• Jiménez, Unai
• Hernanz, Raul
• Mielgo-Rubio, Xabier
• Trujillo-Reyes, Juan Carlos
• Couñago, Felipe

Titel

Neoadjuvant treatment in non-small cell lung cancer: New perspectives with the incorporation of immunotherapy

Ist Teil von

• World journal of clinical oncology, 2022-05, Vol.13 (5), p.314-322

Ort / Verlag

United States: Baishideng Publishing Group Inc

Erscheinungsjahr

2022

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• The aim of neoadjuvant treatment in non-small cell lung cancer (NSCLC) is to eliminate micrometastatic disease to facilitate surgical resection. Neoadjuvant chemotherapy (ChT) in localised NSCLC has numerous advantages over other therapeutic modalities and is considered standard treatment in resectable disease. Treatment with immune checkpoint inhibitors (ICI) improves long-term survival in advanced disease and has a better toxicity profile than conventional therapies. These immunotherapy agents (anti-PD1/PD-L1), administered with or without ChT, are currently being evaluated in the preoperative setting, with initial results showing better pathological response rates and more long-term benefits. Importantly, these drugs do not appear to increase the rate of severe adverse effects and/or postoperative complications. However, several questions still need to be resolved, including the identification of predictive biomarkers; comparative studies of immunotherapy alone combined treatment with ChT and/or radiotherapy; the optimal duration of treatment; the timing of surgery; the need for adjuvant treatment; appropriate radiologic evaluation and mediastinal staging; and the correlation between pathological response and survival outcomes. Here we review the current evidence for immunotherapy from a multidisciplinary perspective and discuss current and future controversies.