Dancing with the Surgeon: Neoadjuvant and Adjuvant Immunotherapies from the Medical Oncologist’s Perspective
Perioperative treatment with conventional cytotoxic chemotherapy for resectable nonsmall cell lung cancer (NSCLC) has proven clinical benefits in terms of achieving a higher overall survival (OS) rate. With its success in the palliative treatment of NSCLC, immune checkpoint blockade (ICB) has now...
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| Format: | Article |
| Language: | English |
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Korean Society for Thoracic & Cardiovascular Surgery
2023-03-01
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| Series: | Journal of Chest Surgery |
| Subjects: |
| _version_ | 1811160793307152384 |
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| author | Sehhoon Park |
| author_facet | Sehhoon Park |
| author_sort | Sehhoon Park |
| collection | DOAJ |
| description | Perioperative treatment with conventional cytotoxic chemotherapy for resectable nonsmall
cell lung cancer (NSCLC) has proven clinical benefits in terms of achieving a higher
overall survival (OS) rate. With its success in the palliative treatment of NSCLC, immune
checkpoint blockade (ICB) has now become an essential component of treatment, even as
neoadjuvant or adjuvant therapy in patients with operable NSCLC. Both pre- and post-surgery
ICB applications have proven clinical efficacy in preventing disease recurrence. In addition,
neoadjuvant ICB combined with cytotoxic chemotherapy has shown a significantly
higher rate of pathologic regression of viable tumors compared with cytotoxic chemotherapy
alone. To confirm this, an early signal of OS benefit has been shown in a selected
population, with programmed death ligand 1 expression ≥50%. Furthermore, applying ICB
both pre- and post-surgery enhances its clinical benefits, as is currently under evaluation
in ongoing phase III trials. Simultaneously, as the number of available perioperative treatment
options increases, the variables to be considered for making treatment decisions become
more complex. Thus, the role of a multidisciplinary team-based treatment approach
has not been fully emphasized. This review presents up-to-date pivotal data that lead to
practical changes in managing resectable NSCLC. From the medical oncologist’s perspective,
it is time to dance with surgeons to decide on the sequence of systemic treatment,
particularly the ICB-based approach, accompanying surgery for operable NSCLC. |
| first_indexed | 2024-04-10T06:03:31Z |
| format | Article |
| id | doaj.art-1ac48aaf573842959eb8fe46b2579ba3 |
| institution | Directory Open Access Journal |
| issn | 2765-1606 2765-1614 |
| language | English |
| last_indexed | 2024-04-10T06:03:31Z |
| publishDate | 2023-03-01 |
| publisher | Korean Society for Thoracic & Cardiovascular Surgery |
| record_format | Article |
| series | Journal of Chest Surgery |
| spelling | doaj.art-1ac48aaf573842959eb8fe46b2579ba32023-03-03T04:41:30ZengKorean Society for Thoracic & Cardiovascular SurgeryJournal of Chest Surgery2765-16062765-16142023-03-01562677410.5090/jcs.23.009Dancing with the Surgeon: Neoadjuvant and Adjuvant Immunotherapies from the Medical Oncologist’s PerspectiveSehhoon Park0https://orcid.org/0000-0001-9467-461XSungkyunkwan University School of MedicinePerioperative treatment with conventional cytotoxic chemotherapy for resectable nonsmall cell lung cancer (NSCLC) has proven clinical benefits in terms of achieving a higher overall survival (OS) rate. With its success in the palliative treatment of NSCLC, immune checkpoint blockade (ICB) has now become an essential component of treatment, even as neoadjuvant or adjuvant therapy in patients with operable NSCLC. Both pre- and post-surgery ICB applications have proven clinical efficacy in preventing disease recurrence. In addition, neoadjuvant ICB combined with cytotoxic chemotherapy has shown a significantly higher rate of pathologic regression of viable tumors compared with cytotoxic chemotherapy alone. To confirm this, an early signal of OS benefit has been shown in a selected population, with programmed death ligand 1 expression ≥50%. Furthermore, applying ICB both pre- and post-surgery enhances its clinical benefits, as is currently under evaluation in ongoing phase III trials. Simultaneously, as the number of available perioperative treatment options increases, the variables to be considered for making treatment decisions become more complex. Thus, the role of a multidisciplinary team-based treatment approach has not been fully emphasized. This review presents up-to-date pivotal data that lead to practical changes in managing resectable NSCLC. From the medical oncologist’s perspective, it is time to dance with surgeons to decide on the sequence of systemic treatment, particularly the ICB-based approach, accompanying surgery for operable NSCLC.immune checkpoint inhibitorsneoadjuvant therapyadjuvant therapynonsmall- cell lung carcinoma |
| spellingShingle | Sehhoon Park Dancing with the Surgeon: Neoadjuvant and Adjuvant Immunotherapies from the Medical Oncologist’s Perspective Journal of Chest Surgery immune checkpoint inhibitors neoadjuvant therapy adjuvant therapy nonsmall- cell lung carcinoma |
| title | Dancing with the Surgeon: Neoadjuvant and Adjuvant Immunotherapies from the Medical Oncologist’s Perspective |
| title_full | Dancing with the Surgeon: Neoadjuvant and Adjuvant Immunotherapies from the Medical Oncologist’s Perspective |
| title_fullStr | Dancing with the Surgeon: Neoadjuvant and Adjuvant Immunotherapies from the Medical Oncologist’s Perspective |
| title_full_unstemmed | Dancing with the Surgeon: Neoadjuvant and Adjuvant Immunotherapies from the Medical Oncologist’s Perspective |
| title_short | Dancing with the Surgeon: Neoadjuvant and Adjuvant Immunotherapies from the Medical Oncologist’s Perspective |
| title_sort | dancing with the surgeon neoadjuvant and adjuvant immunotherapies from the medical oncologist s perspective |
| topic | immune checkpoint inhibitors neoadjuvant therapy adjuvant therapy nonsmall- cell lung carcinoma |
| work_keys_str_mv | AT sehhoonpark dancingwiththesurgeonneoadjuvantandadjuvantimmunotherapiesfromthemedicaloncologistsperspective |