Related Experiment Video
Updated: Mar 20, 2026
Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer
Published on: February 27, 2026
Recent Advances in Combined Medical and Surgical Therapy for Resectable NSCLC
Adithya Balasubramanian1,2,3,4, James Geng1, Catherine Williams1
1Department of Medical Oncology, The Peter MacCallum Cancer Centre, Melbourne, Australia.
Abstract:
Non-small cell lung cancer (NSCLC) remains the leading cause of cancer related mortality. Historically, even among patients with resectable disease, most would not survive 5 years after curative intent surgery. However, outcomes continue to improve through parallel advances in surgery and systemic therapy, the latter aiming to eradicate micrometastatic disease that underpins NSCLC relapse. The advent of precision oncology has transformed the management of oncogene-addicted NSCLC, with tyrosine kinase inhibitors (TKIs) demonstrating significant survival improvements in advanced disease. These agents are now demonstrating their efficacy in molecularly defined subsets of resectable NSCLC-specifically EGFR and ALK mutant tumours-whereby adjuvant TKI therapy significantly reduces recurrence compared with historical platinum-based chemotherapy. In parallel, the immunotherapeutic era has ushered in a new paradigm of curative intent therapy, with immune checkpoint inhibitors (ICIs) improving pathological responses and survival in the perioperative setting. Together, these developments continue to redefine personalised, optimal treatment algorithms for resectable NSCLC. This review outlines the biological rationale and clinical evidence for utilising systemic therapy in the perioperative management of NSCLC. We discuss emerging strategies- such as biomarker-driven, risk-adapted and multimodal approaches- designed to further mitigate the risk of potentially fatal relapse whilst avoiding overtreatment for patients with resectable disease.
Insights
Systemic therapies, including tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs), are improving survival for resectable non-small cell lung cancer (NSCLC). These treatments are redefining personalized perioperative management strategies for NSCLC patients.
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.
More Related Videos
04:04Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
08:54Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
Published on: May 8, 2018
