Department of Cancer Medicine, Gustave Roussy, Villejuif, France.
Department of Medical Oncology, National Cancer Centre Singapore, Duke-National University of Singapore Oncology Academic Clinical Programme, Singapore.
J Thorac Oncol. 2024 Feb;19(2):199-215. doi: 10.1016/j.jtho.2023.09.1451. Epub 2023 Sep 30.
Treatment with 3 years of adjuvant osimertinib is considered a new standard in patients with completely resected stage I to IIIA NSCLC harboring a common sensitizing EGFR mutation. This therapeutic approach significantly prolonged the disease-free survival and the overall survival versus placebo and revealed a significant role in preventing the occurrence of brain metastases. However, many unanswered questions remain, including the optimal duration of this therapy, whether all patients benefit from adjuvant osimertinib, and the role of adjuvant chemotherapy in this population. Indeed, there is a renewed interest in neoadjuvant strategies with targeted therapies in resectable NSCLC harboring oncogenic drivers. In light of these considerations, we discuss the past and current treatment options, and the clinical challenges that should be addressed to optimize the treatment outcomes in this patient population.
对于携带常见敏感 EGFR 突变的完全切除的 I 期至 IIIA 期 NSCLC 患者，接受 3 年辅助奥希替尼治疗被认为是一种新的标准治疗方法。这种治疗方法显著延长了无病生存期和总生存期，与安慰剂相比，显著降低了脑转移的发生风险。然而，仍有许多悬而未决的问题，包括这种治疗的最佳持续时间、所有患者是否都能从辅助奥希替尼治疗中获益，以及辅助化疗在这一人群中的作用。事实上，对于携带致癌驱动基因的可切除 NSCLC 患者，靶向治疗的新辅助策略重新引起了人们的兴趣。有鉴于此，我们讨论了过去和当前的治疗选择，以及为了优化这一患者群体的治疗结果而需要解决的临床挑战。
