Les traitements périopératoires des cancers bronchiques non à petites cellules (CBNPC) : standards actuels et perspectives – de la chimiothérapie aux inhibiteurs des checkpoints immunitaires: Perioperative treatments for non-small cell lung cancer (NSCLC): Current standards and perspectives – from chemotherapy to immune checkpoint inhibitors

Abstract

Surgery is the standard treatment for stage I to IIIA NSCLC. Several randomized phase III trials of adjuvant or neoadjuvant chemotherapy with platinum-based chemotherapy have been carried out, demonstrating a significant survival gain estimated at 5 % at 5 years in stages II and IIIA. This benefit has been confirmed by two meta-analyses based on individual data. In stage I, however, the benefit of chemotherapy has only been suggested for stages IB > 4 cm. The Lung-ART/IFCT-0503 trial recently showed that adjuvant radiotherapy has no place in N2 resected tumors. Immunotherapy is taking its place in the perioperative stages. Two Phase 3 trials have shown adjuvant benefit, but have not been approved in Europe on the basis of current data. Four phase III trials Checkmate-81, Neotorch, AEGEAN and KEYNOTE-671 have shown significant benefit from combining an immune checkpoint inhibitor with chemotherapy in the neoadjuvant setting, with European approval based on the results of Checkmate-816 in patients with PD-L1 ≥ 1 %.1877-1203/© 2023 SPLF. Published by Elsevier Masson SAS. All rights reserved.