Targeted Therapy and Immunotherapy in Early-Stage Non-Small Cell Lung Cancer: Current Evidence and Ongoing Trials
The scenario of neoadjuvant and adjuvant settings in non-small cell lung cancer (NSCLC) is rapidly evolving. As already happened for the advanced disease, also early stages have entered the era of precision medicine, with molecular analysis and Programmed death-ligand 1 (PD-L1) evaluation that by no...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-06-01
|
| Series: | International Journal of Molecular Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1422-0067/23/13/7222 |
| _version_ | 1797479648471285760 |
|---|---|
| author | Marco de Scordilli Anna Michelotti Elisa Bertoli Elisa De Carlo Alessandro Del Conte Alessandra Bearz |
| author_facet | Marco de Scordilli Anna Michelotti Elisa Bertoli Elisa De Carlo Alessandro Del Conte Alessandra Bearz |
| author_sort | Marco de Scordilli |
| collection | DOAJ |
| description | The scenario of neoadjuvant and adjuvant settings in non-small cell lung cancer (NSCLC) is rapidly evolving. As already happened for the advanced disease, also early stages have entered the era of precision medicine, with molecular analysis and Programmed death-ligand 1 (PD-L1) evaluation that by now can be considered a routine assessment. New treatment options have been recently approved, with osimertinib now part of clinical practice for Epidermal Growth Factor Receptor mutated (EGFRm) patients, and immune checkpoint inhibitors (ICIs) available after FDA approval both in the adjuvant (atezolizumab) and neoadjuvant (nivolumab) setting. No mature data on overall survival benefits are available yet, though. Several clinical trials with specific-tyrosine kinase inhibitors (TKIs) and ICIs are currently ongoing, both with and without concomitant chemotherapy. As therapeutic strategies are rapidly expanding, quite a few questions remain unsettled, such as the optimal duration of adjuvant targeted therapy or the effective benefit of ICIs in early-stage EGFRm or ALK (Anaplastic Lymphoma Kinase) rearranged patients, or the possibility to individuate high-risk patients after surgical resection assessing minimal residual disease (MRD) by ctDNA evaluation. We hereby report already available literature data and summarize ongoing trials with targeted therapy and immunotherapy in early-stage NSCLC, focusing on practice-changing results and new perspectives for potentially cured patients. |
| first_indexed | 2024-03-09T21:48:50Z |
| format | Article |
| id | doaj.art-5378efc9221a4730ae93a07519f0c82c |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-09T21:48:50Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-5378efc9221a4730ae93a07519f0c82c2023-11-23T20:10:10ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672022-06-012313722210.3390/ijms23137222Targeted Therapy and Immunotherapy in Early-Stage Non-Small Cell Lung Cancer: Current Evidence and Ongoing TrialsMarco de Scordilli0Anna Michelotti1Elisa Bertoli2Elisa De Carlo3Alessandro Del Conte4Alessandra Bearz5Department of Medicine (DAME), University of Udine, 33100 Udine, ItalyDepartment of Medicine (DAME), University of Udine, 33100 Udine, ItalyDepartment of Medicine (DAME), University of Udine, 33100 Udine, ItalyDepartment of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, ItalyDepartment of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, ItalyDepartment of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, ItalyThe scenario of neoadjuvant and adjuvant settings in non-small cell lung cancer (NSCLC) is rapidly evolving. As already happened for the advanced disease, also early stages have entered the era of precision medicine, with molecular analysis and Programmed death-ligand 1 (PD-L1) evaluation that by now can be considered a routine assessment. New treatment options have been recently approved, with osimertinib now part of clinical practice for Epidermal Growth Factor Receptor mutated (EGFRm) patients, and immune checkpoint inhibitors (ICIs) available after FDA approval both in the adjuvant (atezolizumab) and neoadjuvant (nivolumab) setting. No mature data on overall survival benefits are available yet, though. Several clinical trials with specific-tyrosine kinase inhibitors (TKIs) and ICIs are currently ongoing, both with and without concomitant chemotherapy. As therapeutic strategies are rapidly expanding, quite a few questions remain unsettled, such as the optimal duration of adjuvant targeted therapy or the effective benefit of ICIs in early-stage EGFRm or ALK (Anaplastic Lymphoma Kinase) rearranged patients, or the possibility to individuate high-risk patients after surgical resection assessing minimal residual disease (MRD) by ctDNA evaluation. We hereby report already available literature data and summarize ongoing trials with targeted therapy and immunotherapy in early-stage NSCLC, focusing on practice-changing results and new perspectives for potentially cured patients.https://www.mdpi.com/1422-0067/23/13/7222non-small cell lung cancerearly stageadjuvant therapyneoadjuvant therapytargeted therapytyrosine kinase inhibitors |
| spellingShingle | Marco de Scordilli Anna Michelotti Elisa Bertoli Elisa De Carlo Alessandro Del Conte Alessandra Bearz Targeted Therapy and Immunotherapy in Early-Stage Non-Small Cell Lung Cancer: Current Evidence and Ongoing Trials International Journal of Molecular Sciences non-small cell lung cancer early stage adjuvant therapy neoadjuvant therapy targeted therapy tyrosine kinase inhibitors |
| title | Targeted Therapy and Immunotherapy in Early-Stage Non-Small Cell Lung Cancer: Current Evidence and Ongoing Trials |
| title_full | Targeted Therapy and Immunotherapy in Early-Stage Non-Small Cell Lung Cancer: Current Evidence and Ongoing Trials |
| title_fullStr | Targeted Therapy and Immunotherapy in Early-Stage Non-Small Cell Lung Cancer: Current Evidence and Ongoing Trials |
| title_full_unstemmed | Targeted Therapy and Immunotherapy in Early-Stage Non-Small Cell Lung Cancer: Current Evidence and Ongoing Trials |
| title_short | Targeted Therapy and Immunotherapy in Early-Stage Non-Small Cell Lung Cancer: Current Evidence and Ongoing Trials |
| title_sort | targeted therapy and immunotherapy in early stage non small cell lung cancer current evidence and ongoing trials |
| topic | non-small cell lung cancer early stage adjuvant therapy neoadjuvant therapy targeted therapy tyrosine kinase inhibitors |
| url | https://www.mdpi.com/1422-0067/23/13/7222 |
| work_keys_str_mv | AT marcodescordilli targetedtherapyandimmunotherapyinearlystagenonsmallcelllungcancercurrentevidenceandongoingtrials AT annamichelotti targetedtherapyandimmunotherapyinearlystagenonsmallcelllungcancercurrentevidenceandongoingtrials AT elisabertoli targetedtherapyandimmunotherapyinearlystagenonsmallcelllungcancercurrentevidenceandongoingtrials AT elisadecarlo targetedtherapyandimmunotherapyinearlystagenonsmallcelllungcancercurrentevidenceandongoingtrials AT alessandrodelconte targetedtherapyandimmunotherapyinearlystagenonsmallcelllungcancercurrentevidenceandongoingtrials AT alessandrabearz targetedtherapyandimmunotherapyinearlystagenonsmallcelllungcancercurrentevidenceandongoingtrials |