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Published on: February 12, 2017
Adjuvant or neoadjuvant chemotherapy in minimal N2 stage IIIA nonsmall cell lung cancer
Sofie De Craene1, Veerle Surmont, Jan P van Meerbeeck
1Department of Respiratory Medicine and Thoracic Oncology, University Hospital Ghent, Belgium.
Purpose Of Review:
In the last decade, numerous randomized trials have evaluated the benefit of (neo-)adjuvant chemotherapy in nonsmall cell lung cancer. This article will review the recent data on perioperative chemotherapy in stage III A-N2 nonsmall cell lung cancer and future research opportunities are presented.
Recent Findings:
Four retrospective series, two phase 2 and four phase 3 trials in the neoadjuvant setting and one retrospective series, two phase 2 trials and two phase 3 trials in the adjuvant setting are retrieved and discussed.
Summary:
The available evidence does not allow to change the current recommendation regarding the management of patients presenting with biopsy-proven clinical stage IIIA-N2 nonsmall cell lung cancer: their preferred treatment is chemoradiotherapy. Surgery with neoadjuvant or adjuvant chemotherapy is not proven superior to radiotherapy. The patient occasionally presenting with unforeseen pN2 despite adequate preoperative mediastinal staging should be offered adjuvant cisplatin-based chemotherapy and possibly postoperative radiotherapy.
