Evolution of systemic therapy for stages I–III non-metastatic non-small-cell lung cancer Review


Authors: Chaft, J. E.; Rimner, A.; Weder, W.; Azzoli, C. G.; Kris, M. G.; Cascone, T.
Review Title: Evolution of systemic therapy for stages I–III non-metastatic non-small-cell lung cancer
Abstract: The treatment goal for patients with early-stage lung cancer is cure. Multidisciplinary discussions of surgical resectability and medical operability determine the modality of definitive local treatment (surgery or radiotherapy) and the associated systemic therapies to further improve the likelihood of cure. Trial evidence supports cisplatin-based adjuvant therapy either after surgical resection or concurrently with radiotherapy. Consensus guidelines support neoadjuvant chemotherapy in lieu of adjuvant chemotherapy and carboplatin-based regimens for patients who are ineligible for cisplatin. The incorporation of newer agents, now standard for patients with stage IV lung cancer, into the curative therapy paradigm has lagged owing to inefficient trial designs, the lengthy follow-up needed to assess survival end points and a developmental focus on the advanced-stage disease setting. Surrogate end points, such as pathological response, are being studied and might shorten trial durations. In 2018, the anti-PD-L1 antibody durvalumab was approved for patients with stage III lung cancer after concurrent chemoradiotherapy. Since then, the study of targeted therapies and immunotherapies in patients with early-stage lung cancer has rapidly expanded. In this Review, we present the current considerations in the treatment of patients with early-stage lung cancer and explore the current and future state of clinical research to develop systemic therapies for non-metastatic lung cancer. © 2021, Springer Nature Limited.
Journal Title: Nature Reviews Clinical Oncology
Volume: 18
Issue: 9
ISSN: 1759-4774
Publisher: Nature Publishing Group  
Date Published: 2021-09-01
Start Page: 547
End Page: 557
Language: English
DOI: 10.1038/s41571-021-00501-4
PUBMED: 33911215
PROVIDER: scopus
DOI/URL:
Notes: Review -- Export Date: 1 October 2021 -- Source: Scopus
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  1. Jamie Erin Chaft
    289 Chaft
  2. Andreas Rimner
    524 Rimner
  3. Mark Kris
    869 Kris