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Neoadjuvant Chemoimmunotherapy in Patients with Resectable Non-small Cell Lung Cancer

  • Lung Cancer (TA Leal, Section Editor)
  • Published:
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Opinion statement

Worldwide, lung cancer is the most common cause of cancer morbidity and mortality. Despite a trend towards an escalating diagnosis of resectable non-small cell lung cancer (NSCLC), overall survival (OS) in patients with resectable NSCLC remains poor. The incorporation of chemotherapy into the neoadjuvant setting has improved disease-free survival (DFS), time to distant recurrence, and OS. Furthermore, the incorporation of immunotherapy and the combination of chemotherapy and immunotherapy have improved pathological responses, which seems to be associated with increased survival. Therefore, immunotherapy represents a paradigm shift in treating resectable NSCLC. However, validation in large randomized trials is mandatory and a longer postoperative follow-up period is required. Additionally, neoadjuvant therapy trials offer an exceptional environment for testing predictive biomarkers. PD-L1 expression and tumor mutational burden (TMB) are the most helpful tools for predicting the likelihood of response with immunotherapy in metastatic NSCLC. However, in the neoadjuvant setting, PD-L1 expression and TMB have had opposite results until now. Recently, the immune profiling and some immune-related genes also appear to be involved in the prognosis and response to immunotherapy in NSCLC. Further prospective studies are needed to derive definitive conclusions.

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  1. Oncology Department, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain

    Laura Gutierrez-Sainz, Patricia Cruz-Castellanos & Oliver Higuera

  2. Oncology Department, Hospital Universitario La Paz, Cátedra UAM-AMGEN, CIBERONC, Paseo de la Castellana 261, 28046, Madrid, Spain

    Javier de Castro-Carpeño

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  1. Laura Gutierrez-Sainz
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Laura Gutierrez Sainz declares that she has no conflict of interest. Patricia Cruz Castellanos declares that she has no conflict of interest. Oliver Higuera declares that he has no conflict of interest. Javier de Castro Carpeño declares that he has no conflict of interest.

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Gutierrez-Sainz, L., Cruz-Castellanos, P., Higuera, O. et al. Neoadjuvant Chemoimmunotherapy in Patients with Resectable Non-small Cell Lung Cancer. Curr. Treat. Options in Oncol. 22, 91 (2021). https://doi.org/10.1007/s11864-021-00885-6

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