Neoadjuvant chemotherapy and immunotherapy have emerged as transformative approaches in the treatment of non-small cell lung cancer (NSCLC), reshaping the landscape of therapeutic strategies. By administering these treatments before surgical resection, there has been a remarkable increase in the rate of pathological complete response (Path CR) and major pathological response.
Patients who receive neoadjuvant therapy are experiencing higher rates of tumor regression and, consequently, improved outcomes post-surgery. This combination strategy not only aids in shrinking tumors, making them more operable, but also primes the immune system to potentially recognize and target residual cancer cells.
Trials in Neo-adjuvant/adjuvant setting, response rate, tumor stage:
However, there are still several unanswered questions in this evolving field. One critical question pertains to the optimal duration of neoadjuvant therapy. It remains uncertain whether 3 cycles of treatment are as effective as 4 cycles or whether the additional cycle offers substantial benefits. Furthermore, the duration of adjuvant immunotherapy is another critical concern.
Balancing the benefits and potential side effects, clinicians are pondering the ideal duration for adjuvant immunotherapy, ranging from no additional treatment to various durations like 3 months, 6 months, or even a full year.
These aspects represent pivotal areas of ongoing research and clinical trials, with the aim of refining and tailoring treatment regimens to maximize both efficacy and patient safety in the evolving landscape of NSCLC therapy.
