Recent Advances in Combined Medical and Surgical Therapy for Resectable NSCLC

Area of Science:

• Oncology
• Translational Medicine
• Surgical Oncology

Background:

• Non-small cell lung cancer (NSCLC) is a leading cause of cancer mortality, with historically poor survival rates even after curative surgery.
• Advances in systemic therapies aim to eradicate micrometastatic disease, a key factor in NSCLC relapse.
• Precision oncology and immunotherapy have revolutionized advanced NSCLC treatment.

Purpose of the Study:

• To review the biological rationale and clinical evidence for perioperative systemic therapy in NSCLC.
• To discuss emerging strategies for personalized treatment of resectable NSCLC.
• To explore risk-adapted and multimodal approaches to mitigate relapse while avoiding overtreatment.

Main Methods:

• Review of current literature on systemic therapies in resectable NSCLC.
• Analysis of clinical trial data for tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs).
• Discussion of biomarker-driven and multimodal treatment strategies.

Main Results:

• TKIs show significant survival benefits in EGFR and ALK-mutant resectable NSCLC, reducing recurrence compared to chemotherapy.
• Immune checkpoint inhibitors (ICIs) improve pathological responses and survival in the perioperative setting for NSCLC.
• Combined advances in surgery and systemic therapy are redefining treatment algorithms.

Conclusions:

• Perioperative systemic therapy is integral to improving outcomes for resectable NSCLC.
• Personalized, biomarker-driven approaches are essential for optimizing treatment.
• Future strategies focus on risk stratification and multimodal therapies to balance efficacy and toxicity.