Perioperative Immunotherapy for Non-Small Cell Lung Cancer (NSCLC)

This review explores the use of perioperative immunotherapy for early-stage non-small cell lung cancers (NSCLCs), highlighting key recent developments in the field, questions that remain, and perspectives on their future use.

Immunotherapy has seen a recent expansion of its use to earlier-stage settings, previously limited to advanced/metastatic cancers, with widespread regulatory adoption of immune checkpoint inhibitors (ICIs) into the perioperative setting of resectable early-stage (IB-IIIA) NSCLC. However, questions remain regarding the efficacy of different drug regimens, their duration and scheduling, and, in particular, combinations with other therapies. The use of ICIs alongside molecularly targeted therapy has prompted well-evidenced concerns around toxicity and efficacy, with focus shifting to alternative strategies. Promising findings are seen with the revolutionary use of antibody drug conjugates (ADCs) in various cancer fields, prompting growing interest and a number of trials investigating their use, including combined with immunotherapy, within lung cancer. While promising as a therapy, the full potential of perioperative immunotherapy still remains to be realised, to be aided by further research into optimisation of treatment regimens and combinatorial strategies.