Salvage lung surgery in long-term survivors after biological and immunotherapeutic treatments

Abstract

: Despite increasing efforts regarding screening and early detection, the majority of new lung cancers are still diagnosed at an advanced stage. For advanced cases of non-small cell lung cancer (NSCLC), treatment is often based on systemic chemoradiotherapy (CRT). However, in the last few decades, emerging modalities such as targeted therapy and immunotherapy have altered treatment paradigms, and have vastly improved overall and disease-free survival for a large group of patients. Furthermore, tumours that were initially deemed inoperable may now demonstrate a downstaging of their cancer to operable disease status. In these patients, salvage lung resections can be considered as a treatment to obtain complete resection. However, data on patient selection criteria, optimal surgical timing, postoperative complications, and outcomes of salvage surgery in patients receiving these systemic therapies are scarce. In this review, we aim to summarize the most recent literature regarding salvage lung surgery in patients that have received targeted therapy or immunotherapy.