Updates on the Perioperative Management of Resectable Non-Small Cell Lung Cancer.

Area of Science:

• Medical Oncology
• Thoracic Surgery
• Pulmonology

Background:

• Historically, chemotherapy was the sole systemic treatment for resectable non-small cell lung cancer (NSCLC).
• Recent advancements incorporate targeted therapies and immunotherapies, significantly improving outcomes.
• Treatment personalization based on biomarker selection is now standard practice.

Purpose of the Study:

• To review the current landscape of systemic treatments for resectable non-small cell lung cancer (NSCLC).
• To discuss patient selection, staging, and resectability assessment.
• To highlight the roles of immunotherapy and targeted therapy, including biomarker implications.

Main Methods:

• This is a narrative review of current systemic treatment strategies for resectable NSCLC.
• The review synthesizes data on immunotherapy and targeted therapy in neoadjuvant, adjuvant, and perioperative settings.
• It emphasizes patient selection, staging, and biomarker identification (e.g., PD-L1, EGFR, ALK).

Main Results:

• Immunotherapy-based regimens are increasingly important in neoadjuvant, adjuvant, and perioperative settings.
• Targeted therapies show efficacy, particularly in the adjuvant setting for NSCLC with EGFR mutations or ALK rearrangements.
• PD-L1 status significantly impacts clinical outcomes in immunotherapy treatment decisions.

Conclusions:

• Systemic treatment for resectable NSCLC has evolved to include personalized immunotherapy and targeted therapy.
• Appropriate patient selection, staging, and biomarker identification are crucial for optimizing treatment.
• Ongoing research continues to refine perioperative and adjuvant strategies for NSCLC.