Houda Ilias, Dickhoff Chris, Uyl-de Groot Carin A, Damhuis Ronald A M, Reguart Noemi, Provencio Mariano, Levy Antonin, Dziadziuszko Rafal, Pompili Cecilia, Di Maio Massimo, Thomas Michael, Brunelli Alessandro, Popat Sanjay, Senan Suresh, Bahce Idris
Department of Pulmonary Medicine, Amsterdam UMC, Location VU Medical Center, Cancer Center Amsterdam, de Boelelaan 1117, 1081HV Amsterdam, the Netherlands.
Department of Cardiothoracic Surgery, Amsterdam UMC, Location VU Medical Center, Cancer Center Amsterdam, de Boelelaan 1117, 1081HV Amsterdam, the Netherlands.
Lancet Reg Health Eur. 2024 Mar 1;38:100841. doi: 10.1016/j.lanepe.2024.100841. eCollection 2024 Mar.
The treatment landscape of resectable early-stage non-small cell lung cancer (NSCLC) is transforming due to the approval of novel adjuvant and neoadjuvant systemic treatments. The European Medicines Agency (EMA) recently approved adjuvant osimertinib, adjuvant atezolizumab, adjuvant pembrolizumab, and neoadjuvant nivolumab combined with chemotherapy, and the approval of other agents or new indications may follow soon. Despite encouraging results, many unaddressed questions remain. Moreover, the transformed treatment paradigm in resectable NSCLC can pose major challenges to healthcare systems and magnify existing disparities in care as differences in reimbursement may vary across different European countries. This Viewpoint discusses the challenges and controversies in resectable early-stage NSCLC and how existing inequalities in access to these treatments could be addressed.
由于新型辅助和新辅助全身治疗药物的获批,可切除早期非小细胞肺癌(NSCLC)的治疗格局正在发生转变。欧洲药品管理局(EMA)最近批准了辅助使用奥希替尼、辅助使用阿替利珠单抗、辅助使用帕博利珠单抗以及新辅助使用纳武利尤单抗联合化疗,其他药物或新适应症可能也将很快获批。尽管取得了令人鼓舞的结果,但仍有许多问题尚未得到解决。此外,可切除NSCLC治疗模式的转变可能给医疗系统带来重大挑战,并加剧现有的医疗差距,因为不同欧洲国家的报销差异可能各不相同。本观点讨论了可切除早期NSCLC的挑战和争议,以及如何解决这些治疗可及性方面现有的不平等问题。