Challenges and controversies in resectable non-small cell lung cancer: a clinician's perspective

Area of Science:

• Medical Oncology
• Thoracic Surgery
• Health Policy

Background:

• The treatment of resectable early-stage non-small cell lung cancer (NSCLC) is rapidly evolving.
• Recent approvals of novel adjuvant and neoadjuvant systemic therapies by the European Medicines Agency (EMA) mark a significant shift.
• These include adjuvant osimertinib, adjuvant atezolizumab, adjuvant pembrolizumab, and neoadjuvant nivolumab with chemotherapy.

Purpose of the Study:

• To discuss the emerging challenges and controversies in the management of resectable early-stage NSCLC.
• To highlight potential inequalities in access to new treatments across European countries.
• To propose strategies for addressing disparities in care.

Main Methods:

• This is a viewpoint discussion based on current clinical practice and emerging data.
• Analysis of recent regulatory approvals and their implications.
• Consideration of healthcare system impacts and equity issues.

Main Results:

• The landscape of resectable early-stage NSCLC treatment is being redefined by new systemic therapies.
• Significant questions remain regarding optimal use and long-term outcomes.
• Healthcare systems face challenges related to reimbursement and potential exacerbation of care disparities.

Conclusions:

• The integration of novel systemic treatments offers promising advancements for resectable early-stage NSCLC.
• Addressing healthcare system challenges and ensuring equitable access across Europe is crucial.
• Further discussion and policy development are needed to navigate this transformed treatment paradigm.