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Updated: Jun 23, 2025

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Immune checkpoint inhibition in early-stage non-small cell lung cancer

Kristof Cuppens1, Bert Du Pont2, Joost Knegjens3

  • 1Department of Pulmonology and Thoracic Oncology and Jessa & Science, Jessa Hospital Hasselt, Belgium; Faculty of Medicine and Life Sciences, LCRC, UHasselt, Diepenbeek, Belgium; Department of Thoracic Oncology, The Netherlands Cancer Institute and Leiden University Medical Center, Amsterdam, the Netherlands.

Lung Cancer (Amsterdam, Netherlands)
|June 19, 2024
PubMed

Insights

Immune checkpoint inhibitors improve non-small cell lung cancer (NSCLC) outcomes but 5-year survival remains suboptimal. This review covers adjuvant, neoadjuvant, and perioperative immunotherapy strategies for early-stage NSCLC.

Area of Science:

  • Oncology
  • Immunotherapy
  • Thoracic Surgery

Background:

  • Immune checkpoint inhibitors (ICIs) have improved outcomes in advanced non-small cell lung cancer (NSCLC).
  • Despite advances, 5-year survival rates for NSCLC remain suboptimal, with frequent relapses in early-stage disease.
  • Adjuvant, neoadjuvant, and perioperative immunotherapy strategies are emerging for early-stage NSCLC.

Purpose of the Study:

  • To comprehensively review current data on perioperative immunotherapy for early-stage NSCLC.
  • To address challenges and perspectives of integrating immunotherapy into early-stage NSCLC treatment paradigms.
  • To synthesize evidence on adjuvant, neoadjuvant, and perioperative treatment strategies.

Main Methods:

  • Systematic literature review of clinical trials and relevant studies.
  • Analysis of data on efficacy and safety of neoadjuvant, adjuvant, and perioperative immunotherapy in NSCLC.
  • Discussion of stakeholder perspectives on treatment challenges.

Main Results:

  • Positive clinical trial data support the integration of immunotherapy in early-stage NSCLC.
  • Ongoing research is evaluating various perioperative immunotherapy regimens.
  • Challenges related to treatment sequencing, toxicity, and patient selection persist.

Conclusions:

  • Perioperative immunotherapy shows promise for improving outcomes in early-stage NSCLC.
  • Further research is needed to optimize treatment strategies and address implementation challenges.
  • Understanding diverse stakeholder perspectives is crucial for successful integration.
Keywords:
Early stageImmune checkpoint inhibitionNeoadjuvantNon-small cell lung cancerPerioperative

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