A Canadian Perspective on Perioperative Systemic Therapy in Resectable Non-Small Cell Lung Cancer.

Area of Science:

• Oncology
• Thoracic Surgery
• Clinical Trials

Background:

• Resectable non-small cell lung cancer (NSCLC) management has evolved.
• Despite surgical advances, recurrence risk remains high.
• Perioperative strategies show improved outcomes in clinical trials.

Purpose of the Study:

• To review recent clinical trial developments in perioperative strategies for early-stage operable NSCLC.
• To contextualize global advancements within the Canadian healthcare framework.
• To guide clinicians on integrating new therapies and addressing implementation challenges.

Main Methods:

• Review of landmark clinical trials in perioperative NSCLC treatment.
• Focus on Canadian perspective for national practice integration.
• Discussion of immunotherapy, adjuvant targeted therapies, and ctDNA monitoring.

Main Results:

• Perioperative approaches demonstrate enhanced response rates, pathological outcomes, and survival.
• Checkpoint inhibitors and adjuvant targeted therapies are key advancements.
• ctDNA-based minimal residual disease monitoring is an emerging tool.

Conclusions:

• Integration of perioperative strategies is crucial for improving resectable NSCLC patient outcomes.
• Addressing Canadian healthcare system challenges (approvals, multidisciplinary care) is essential.
• Optimizing patient care requires adapting to these new therapeutic paradigms.