Angel H. Roffo Cancer Institute, University of Buenos Aires, Buenos Aires, Argentina.
Medical Oncology Unit, A.O Papardo, Messina, Italy.
Expert Rev Anticancer Ther. 2021 Nov;21(11):1229-1235. doi: 10.1080/14737140.2021.1982387. Epub 2021 Sep 25.
Surgical resection is the standard of care (SOC) in non-small cell lung cancer (NSCLC) for early-stage. The 5-year overall survival (OS) rates with the use of adjuvant chemotherapy remain low. In advance NSCLC, tailored strategies have become the gold standard. We hope to translate these benefits into preventing recurrences and increasing survival in early-stage NSCLC.
EGFR mutated populations are the most common druggable molecular drivers in advance NSCLC. EGFR tyrosine kinase inhibitors (TKIs) are the SOC in this setting, and we discuss their emerging role as adjuvant therapy.
The results of the first adjuvant clinical trial with TKIs showed increased DFS in patients with early-stage NSCLC. Despite that using osimertinib (Osm) as an adjuvant treatment seems promising, several open questions need to be answered. If Osm reaches a significant advantage in OS, undergoing 3 years of treatment is worthwhile, but if there is not an OS benefit then maybe DFS is not enough. In the meantime, should we treat patients with Osm as adjuvant therapy until the OS data is available? There is not an easy answer, but most of us are in favor of giving Osm a chance until we have definitive data or better options in early-stage NSCLC.
手术切除是早期非小细胞肺癌（NSCLC）的标准治疗方法（SOC）。使用辅助化疗的 5 年总生存率（OS）仍然较低。在晚期 NSCLC 中，针对性策略已成为金标准。我们希望将这些益处转化为预防早期 NSCLC 复发和提高生存率。
EGFR 突变人群是非小细胞肺癌中最常见的可用药理学驱动因素。EGFR 酪氨酸激酶抑制剂（TKI）是该领域的 SOC，我们讨论了它们作为辅助治疗的新作用。
首个 TKI 辅助临床试验的结果显示，早期 NSCLC 患者的无病生存期（DFS）有所提高。尽管使用奥希替尼（Osimertinib，Osm）作为辅助治疗似乎很有前景，但仍有几个悬而未决的问题需要解答。如果 Osm 在 OS 方面有显著优势，那么进行 3 年的治疗是值得的，但如果 OS 没有获益，那么可能 DFS 还不够。在此期间，我们是否应该用 Osm 治疗辅助治疗患者，直到 OS 数据可用？这没有一个简单的答案，但我们大多数人都赞成在早期 NSCLC 中，在有明确数据或更好的选择之前，给 Osm 一个机会。
