Perioperative targeted therapy for oncogene-driven NSCLC

Area of Science:

• Oncology
• Translational Medicine
• Genomics

Background:

• Targeted therapy is transforming perioperative treatment for early-stage, oncogene-driven non-small-cell lung cancer (NSCLC).
• Practice-changing trials have significantly expanded therapeutic options for potentially curable NSCLC.
• Early trials investigated adjuvant gefitinib (first-generation EGFR-TKI), but the ADAURA study established adjuvant osimertinib as the standard of care for resected EGFR-mutant NSCLC.

Purpose of the Study:

• To review recent breakthroughs in perioperative targeted therapy for oncogene-driven NSCLC.
• To focus on data from published clinical trials evaluating targeted agents.
• To discuss challenges and propose strategies for managing early-stage NSCLC patients.

Main Methods:

• Review of major clinical trials in perioperative targeted therapy for NSCLC.
• Analysis of data concerning EGFR-mutated NSCLC and other molecular alterations (ALK, ROS1, NTRK, BRAF V600, RET).
• Discussion of surgical, pathological, and oncological challenges and management strategies.

Main Results:

• Adjuvant osimertinib has become the standard of care for resected EGFR-mutant NSCLC.
• Targeted agents for other molecular alterations are under evaluation in adjuvant and neoadjuvant settings.
• Ongoing research focuses on biomarker selection, optimal treatment duration, and treatment paradigms.

Conclusions:

• Perioperative targeted therapy offers personalized treatment approaches for oncogene-driven NSCLC.
• Further research is needed to optimize biomarker selection, treatment duration, and clinical management strategies.
• These advancements aim to improve outcomes for patients with early-stage NSCLC.