Neoadjuvant therapy for NSCLC: From monotherapy to precision combination therapy

Area of Science:

• Oncology
• Medical Research

Background:

• Neoadjuvant therapy for non-small cell lung cancer (NSCLC) historically relied on chemotherapy.
• Recent advancements include targeted therapies (e.g., EGFR, ALK inhibitors) and immunotherapies (e.g., PD-1, PD-L1, CTLA-4 inhibitors).

Purpose of the Study:

• To review current advancements in neoadjuvant therapy for NSCLC.
• To discuss future directions and challenges in optimizing neoadjuvant treatment strategies.

Main Methods:

• Literature review of clinical studies and trials on neoadjuvant NSCLC treatments.
• Analysis of the efficacy and limitations of chemotherapy, targeted therapy, and immunotherapy.

Main Results:

• Neoadjuvant combination therapies, including immunotherapy and chemotherapy (e.g., nivolumab plus chemotherapy), improve pathological complete response (pCR) and event-free survival (EFS).
• Significant challenges persist, including drug resistance, the disconnect between pathological response and long-term survival, and limited biomarker predictive accuracy.

Conclusions:

• Neoadjuvant strategies for NSCLC are rapidly advancing with targeted agents and ICIs.
• Future research must focus on developing precise predictive tools for personalized treatment and validating combination regimens to improve clinical efficacy and patient quality of life.