Extract
Current European and American guidelines strongly recommend adjuvant platinum-based chemotherapy in selected patients with radically resected non-small cell lung cancer (NSCLC), based on a quantitative meta-analysis showing an absolute improvement in survival of 4% at 5 years, which was stage dependent (stage pI: 3%, stage pIII: 13%) [1–3]. The occasional N0-tumour with a diameter >4 cm, which was previously classified IB, is upstaged to at least a IIA (pT2bN0) in the 8th TNM classification [4]. Currently, the selection of patients eligible for adjuvant chemotherapy is based on clinical and tumour characteristics, and is restricted to tumours in stages pII and pIII [5]. Compliance with the preferred three to four cycles of a platinum-based two drug combination regimen is moderate, with about two-thirds of patients receiving the planned dose-intensity at a cost of 2–3% mortality.
Abstract
Immuno- and targeted therapy improved survival in metastatic NSCLC, but before their implementation in early disease, several challenges need to be overcome. Adequate staging is important, and molecular testing must be incorporated in early disease.https://bit.ly/3heLe6W
Footnotes
Conflict of interest: L.E.L. Hendriks has no disclosures to make related to the current manuscript; outside of current manuscript: research funding from Roche Genentech, Boehringer Ingelheim, AstraZeneca and Takeda (all institution); advisory board: BMS, Eli Lilly, Roche Genentech, Pfizer, Takeda, MSD, Boehringer Ingelheim, Janssen and Amgen (all institution, Roche also one time self); speaker: MSD (institution); travel/conference reimbursement: Roche Genentech (self); mentorship program with key opinion leaders: funded by AstraZeneca; fees for educational webinars: Medtalks, Benecke, VJOncology (self), high5oncology (institution); interview sessions funded by Roche Genentech (institution); local PI of clinical trials: AstraZeneca, Novartis, BMS, MSD/Merck, GSK, Takeda, Blueprint Medicines, Roche Genentech, Janssen Pharmaceuticals and Mirati; member ESMO and NVALT guideline committees, NVALT studies foundation secretary.
Conflict of interest: J. van Meerbeeck has no disclosures to make related to the current manuscript; outside of the current manuscript: fees for meeting attendance from GlaxoSmithKline, Bristol-Myers Squibb, MSD and AstraZeneca; personal fees for consultancy from Pfizer, Boehringer Ingelheim, Roche, AstraZeneca and Amgen.
Conflict of interest: J. Cadranel has no disclosures to make related to the current manuscript; outside of current manuscript: research funding AbbVie, AstraZeneca, Boehringer Ingelheim, Novartis and Pfizer (institution); fees for advisory boards from AstraZeneca, BMS, Boehringer Ingelheim, MSD, Novartis, Pfizer, Roche and Takeda; local PI of clinical trials: AbbVie, AMGEN, AstraZeneca, BluePrint, BMS, Boehringer Ingelheim, Jansen, Lilly, MSD, Novartis, Pfizer, Roche, Sanofi and Takeda.
- ReceivedJune 9, 2021.
- AcceptedAugust 31, 2021.
- Copyright ©The authors 2021. For reproduction rights and permissions contactpermissions{at}ersnet.org