Targeted Therapies in Early-Stage Resectable Non-Small-Cell Lung Cancer: New Kids on the Block

Area of Science:

• Oncology
• Molecular Biology
• Genetics

Background:

• Next-generation sequencing enables tailored therapies for early-stage resectable non-small-cell lung cancer (NSCLC) based on molecular profiles.
• Targeted therapies are increasingly adopted in the adjuvant and neoadjuvant/adjuvant settings for early-stage NSCLC.

Purpose of the Study:

• To review recent advancements in targeted therapies for early-stage resectable NSCLC.
• Focus on developments in the adjuvant and neoadjuvant/adjuvant settings.

Main Methods:

• Systematic literature search of MEDLINE/PubMed for studies within the last 10 years.
• Focused on prospective and ongoing studies of early-stage NSCLC with tyrosine kinase inhibitors (TKIs), epidermal growth factor receptor (EGFR), and anaplastic lymphoma kinase (ALK).

Main Results:

• Most studies involve EGFR-TKIs in the adjuvant setting for early-stage NSCLC.
• The ADAURA trial is the first to show an overall survival benefit with an adjuvant EGFR-TKI.
• Future research will explore optimal targeted therapy duration and biomarker use (e.g., circulating tumor DNA) for risk stratification.

Conclusions:

• Ongoing studies investigating targeted therapies for neoadjuvant/adjuvant settings and rare mutations (e.g., ALK, ROS1, MET, BRAF V600E) are anticipated.
• The treatment landscape for early-stage NSCLC with actionable mutations is expected to evolve significantly in the next decade.