Mirsky Matthew M, Myers Katherine E, Abul-Khoudoud Sami O, Lee Joan Y, Bruno Debora S
University Hospitals Seidman Cancer Center, Cleveland, OH 44106, USA.
Department of Solid Tumor Oncology, Thoracic Division, Case Western Reserve University, Cleveland, OH 44106, USA.
J Clin Med. 2025 Jun 11;14(12):4127. doi: 10.3390/jcm14124127.
Operable non-small cell lung cancer (NSCLC) has been traditionally managed with surgical resection, often followed by adjuvant chemotherapy with or without radiotherapy. However, disease recurrence still occurs approximately 50% of the time. Most recently, (neo) adjuvant/perioperative systemic therapy has evolved to include checkpoint inhibitor therapy and targeted therapies that have proved successful in advanced disease settings. We provide a comprehensive review of the trials investigating neoadjuvant, adjuvant, and perioperative systemic therapies in resectable lung cancer, including a discussion on surrogate survival endpoints. We review the management of N2 disease, the utility of circulating tumor DNA (ctDNA) in determining the risk and benefit from systemic therapy in operable NSCLC, as well as future directions of investigation.
可手术切除的非小细胞肺癌（NSCLC）传统上采用手术切除治疗，术后常根据情况进行辅助化疗，可联合或不联合放疗。然而，疾病复发率仍约为50%。最近，（新）辅助/围手术期全身治疗已发展为包括检查点抑制剂治疗和靶向治疗，这些治疗在晚期疾病中已被证明是成功的。我们对研究可切除肺癌新辅助、辅助和围手术期全身治疗的试验进行了全面综述，包括对替代生存终点的讨论。我们回顾了N2期疾病的管理、循环肿瘤DNA（ctDNA）在确定可手术NSCLC全身治疗的风险和获益方面的作用，以及未来的研究方向。
