Immunotherapy for Early-Stage Non–Small Cell Lung Cancer: A Practical Guide of Current Controversies

IF 3.3 3区 医学 Q2 ONCOLOGY Clinical lung cancer Pub Date : 2025-05-01 Epub Date: 2025-01-15 DOI:10.1016/j.cllc.2025.01.006
William J. Phillips , Ashley Jackson , Biniam Kidane , Gerald Lim , Vishal Navani , Paul Wheatley-Price
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Abstract

The role of immunotherapy as systemic therapy for nonmetastatic non–small cell lung cancer (NSCLC) has evolved rapidly over the last decade. There are several well-conducted phase 3 clinical trials evaluating immunotherapy in the neoadjuvant, perioperative, adjuvant and nonoperative setting. In this narrative review, we summarize the data from these studies and discuss ongoing controversies in applying these data to clinical practice. These controversies relate to the value of the adjuvant component of perioperative immunotherapy, treatment of patients with PDL1 negative tumors, defining resectability, optimal use of operative versus nonoperative management, the role of stereotactic radiation therapy for very early lung cancers, and management of tumors with an oncogenic driver.
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早期非小细胞肺癌的免疫治疗:当前争议的实用指南。
在过去十年中,免疫疗法作为非转移性非小细胞肺癌(NSCLC)的全身疗法的作用发展迅速。有几个进行良好的3期临床试验评估免疫治疗在新辅助,围手术期,辅助和非手术环境。在这篇叙述性综述中,我们总结了这些研究的数据,并讨论了将这些数据应用于临床实践的持续争议。这些争议涉及围手术期免疫治疗辅助成分的价值,PDL1阴性肿瘤患者的治疗,可切除性的定义,手术与非手术治疗的最佳使用,立体定向放疗在早期肺癌中的作用,以及具有致癌驱动因素的肿瘤的治疗。
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来源期刊
Clinical lung cancer
Clinical lung cancer 医学-肿瘤学
CiteScore
7.00
自引率
2.80%
发文量
159
审稿时长
24 days
期刊介绍: Clinical Lung Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of lung cancer. Clinical Lung Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of lung cancer. The main emphasis is on recent scientific developments in all areas related to lung cancer. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.
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