Emerging precision neoadjuvant systemic therapy for patients with resectable non-small cell lung cancer: current status and perspectives

Biomarker Research

Review

Robert J. Knebel¹  Danny Cheng¹  Kyra A. Toomey²  Jag Lally²  Weijie Ma²  Tianhong Li³  Chinh T. Phan⁴  Nicholas Stollenwerk⁴  Luis A. Godoy⁵  Prabhu Rajappa⁶  Shirish Mahajan⁶  Roya Sheridan⁶  Joy Chen⁷ 

[1] Department of Radiology, Interventional Radiology, Veterans Affairs Northern California Health Care System, Mather, CA, USA;Division of Hematology/Oncology, Department of Internal Medicine, University of California Davis School of Medicine, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA;Division of Hematology/Oncology, Department of Internal Medicine, University of California Davis School of Medicine, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA;Medical Service, Hematology and Oncology, Veterans Affairs Northern California Health Care System, Mather, CA, USA;Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of California Davis School of Medicine, Sacramento, CA, USA;Medical Service, Pulmonology, Veterans Affairs Northern California Health Care System, Mather, CA, USA;Division of Thoracic Surgery, Department of Surgery, University of California Davis School of Medicine, Sacramento, CA, USA;Medical Service, Hematology and Oncology, Veterans Affairs Northern California Health Care System, Mather, CA, USA;Medical Student, University of California Davis School of Medicine, Sacramento, CA, USA;

关键词: NSCLC;    Resectable;    Neoadjuvant;    Immune checkpoint inhibitor (ICI);    Targeted therapy;    Precision oncology;    Systemic therapy;   

DOI  :  10.1186/s40364-022-00444-7

 received in 2022-11-23, accepted in 2022-12-16,  发布年份 2022

来源: Springer

【 摘 要 】

Over the past decade, targeted therapy for oncogene-driven NSCLC and immune checkpoint inhibitors for non-oncogene-driven NSCLC, respectively, have greatly improved the survival and quality of life for patients with unresectable NSCLC. Increasingly, these biomarker-guided systemic therapies given before or after surgery have been used in patients with early-stage NSCLC. In March 2022, the US FDA granted the approval of neoadjuvant nivolumab and chemotherapy for patients with stage IB-IIIA NSCLC. Several phase II/III trials are evaluating the clinical efficacy of various neoadjuvant immune checkpoint inhibitor combinations for non-oncogene-driven NSCLC and neoadjuvant molecular targeted therapies for oncogene-driven NSCLC, respectively. However, clinical application of precision neoadjuvant treatment requires a paradigm shift in the biomarker testing and multidisciplinary collaboration at the diagnosis of early-stage NSCLC. In this comprehensive review, we summarize the current diagnosis and treatment landscape, recent advances, new challenges in biomarker testing and endpoint selections, practical considerations for a timely multidisciplinary collaboration at diagnosis, and perspectives in emerging neoadjuvant precision systemic therapy for patients with resectable, early-stage NSCLC. These biomarker-guided neoadjuvant therapies hold the promise to improve surgical and pathological outcomes, reduce systemic recurrences, guide postoperative therapy, and improve cure rates in patients with resectable NSCLC.

【 授权许可】

CC BY   
© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2022

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