Abstract
Lung cancer is worldwide the most common malignancy. Standard of care treatments for early-stage non-small-cell lung cancer (NSCLC) include surgery and adjuvant chemotherapy. However, these patients continue to have poor prognosis due to systemic or local relapse. Immunotherapy has been considered as a novel approach to improve survival in patients with early-stage NSCLC. Since immune checkpoint inhibitors have transformed the treatment of advanced NSCLC, there is a growing interest in the role of immunotherapy in early-stage NSCLC. In this review, we summarize reported and ongoing clinical trials of immunotherapy in both neoadjuvant and adjuvant settings. We also highlight unaddressed issues in this field of research, such as the predictive markers, the optimal combination therapy, and the need for adjuvant immunotherapy. More studies are needed to optimize the treatment regimen of immunotherapy in patients with early-stage NSCLC.
Highlights
Lung cancer is the leading cause of cancer death globally, with an estimated 1.8 million deaths in 2020 [1]
A meta-analysis found that adjuvant chemotherapy gave an absolute survival improvement of 4% at 5 years, compared to surgery alone, to patients with resected early-stage non-small-cell lung cancer (NSCLC) [8]
We examine past and ongoing clinical trials on neoadjuvant and adjuvant immunotherapies for patients with resectable NSCLC
Summary
Lung cancer is the leading cause of cancer death globally, with an estimated 1.8 million deaths in 2020 [1]. Non-small-cell lung cancer (NSCLC) is the most common type of lung cancer, accounting for 85% of all lung cancer diagnoses [2]. NSCLC is divided into three main types: adenocarcinoma, squamous cell carcinoma, and large cell carcinoma [3]. NSCLC is often insidious and undiagnosed until advanced-stage disease is present [4]. 25% of patients with NSCLC have localized disease at the time of diagnosis [5]. Lobectomy followed by systemic adjuvant therapy is considered as standard treatment for patients with resectable NSCLC. 50% of patients with stage II, and 60% of patients with stage IIIA disease die within five years [6].
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