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Targeted Cancer Therapies

Targeted Cancer Therapies

The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
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The Current Consensus on Salvage Surgery after Targeted Therapy for Advanced EGFR-Mutant Non-Small Cell Lung Cancer.

Yu-Wei Liu¹, Po-Chih Chang¹, Jadzia Tin-Tsen Chou²

¹Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Journal of Chest Surgery

|August 6, 2025

Summary

Salvage surgery offers promising disease control for select advanced EGFR-mutant non-small cell lung cancer (NSCLC) patients on tyrosine kinase inhibitor (TKI) therapy. This approach provides tissue for molecular analysis, aiding treatment selection and potentially improving outcomes.

Keywords:

EGFR mutation Non-small-cell lung carcinoma Salvage surgery Targeted therapy Tyrosine kinase inhibitors

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Area of Science:

Oncology
Thoracic Surgery
Molecular Diagnostics

Background:

Advanced epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) presents treatment challenges.
Tyrosine kinase inhibitor (TKI) therapy is a standard treatment, but resistance mechanisms emerge.
Salvage surgery is an emerging strategy for patients with controlled disease on TKI therapy.

Purpose of the Study:

To evaluate the efficacy and role of salvage surgery in advanced EGFR-mutant NSCLC.
To assess oncologic outcomes, including progression-free survival (PFS) and overall survival (OS).
To explore the benefits of tissue acquisition for molecular analysis and resistance mechanism identification.

Main Methods:

Retrospective analysis of fourteen series involving patients undergoing salvage surgery.
Review of reported progression-free survival (PFS) and overall survival (OS) data.
Analysis of factors influencing outcomes, including patient characteristics and tumor biology.

Main Results:

Median PFS ranged from 14-52 months, with OS often exceeding 3 years.
Salvage surgery provides better disease control compared to continued TKI therapy alone in some cohorts.
Tissue analysis facilitates identification of resistance mechanisms (e.g., T790M mutation) and histologic transformation.

Conclusions:

Salvage surgery is a feasible and effective option for carefully selected patients with advanced EGFR-mutant NSCLC, particularly those with oligoresidual disease.
Patient selection should consider performance status, disease extent, histopathology, and genomic profile.
Prospective trials are needed to validate findings and optimize the integration of surgery with novel therapies.