Current Status and Future Perspectives on Neoadjuvant Therapy in Lung Cancer

Abstract

This Review Article provides a multi-stakeholder view on the current status of neoadjuvant therapy in lung cancer. Given the success of oncogene-targeted therapy and immunotherapy for patients with advanced lung cancer, there is a renewed interest in studying these agents in earlier disease settings with the opportunity to have an even greater impact on patient outcomes. There are unique opportunities and challenges with the neoadjuvant approach to drug development. To achieve more rapid knowledge turns, study designs, endpoints, and definitions of pathologic response should be standardized and harmonized. Continued dialogue with all stakeholders will be critical to design and test novel induction strategies, which could expedite drug development for patients with early lung cancer who are at high risk for metastatic recurrence. Published by Elsevier Inc. on behalf of International Association for the Study of Lung Cancer.

Pathologic Assessment After Neoadjuvant Chemotherapy for NSCLC: Importance and Implications of Distinguishing Adenocarcinoma From Squamous Cell Carcinoma

“…It is anticipated that such an approach will be included in future recommendations from the IASLC pathology panel. 39 In conclusion, we have shown that pathologic response after NAC and subsequent survival outcomes differ between histologic types of NSCLC. MPR ( 10% viable tumor) predicts better survival in patients with SCC; however, in patients with ADC, the optimal cutoff percentage of viable tumor may be higher than 10%.…”

Bcl-2 is essential for Foeniculum vulgare seed extract-induced apoptosis in lung cancer

“…Although there has been great progress in the screening, prevention, and treatment of lung cancer, it remains the cancer with the highest incidence and mortality rate, with a five year survival rate of less than 5% [21]. One main reason for the lethality of lung cancer is that there is currently no effective treatment regime for mid and advanced lung cancer, and most patients die due to uncontrolled distant metastasis and recurrence [22,23]. Compared with conventional chemotherapy drugs, such as platinum or paclitaxel, various new molecular targeted drugs such as tyrosine kinase inhibitors including Gefitinib and Erlotinib, or angiogenesis monoclonal antibodies, including Bevacizumab and Ramolumab, have been developed.…”

Expanding anaplastic lymphoma kinase therapeutic indication to early stage non-small cell lung cancer

“…Extended follow-up, prospective and wider validation analyses, including different oncogene-addicted subgroups, could corroborate the evidence of a negative clinical impact of ALK gene translocations. Nevertheless, the undoubted higher number of disease recurrences in this patients' subgroup spurs scientific community to implement peri-operative strategies aiming to a better disease control (9,30).…”

“…However, a large fraction of patients, roughly 50%, relapse with single or multiple metastases and die for lung cancer (5-year survival rate equal to 56%) (6). Having in mind these poor outcomes and lung cancer screening implementation in the very nextfuture, which will increase fraction of surgical patients, is easy to gauge the urgent need of peri-operative (adjuvant and neo-adjuvant) treatment strategies capable to really impact on long-term patients' survival benefit (7)(8)(9). That said, current standard approach in the adjuvant setting is still represented by cisplatin-doublet chemotherapy, based on a survival benefit of 5.4% at 5 years follow up (10).…”