TY - JOUR
T1 - Perioperative treatment strategies in EGFR-mutant early-stage NSCLC
T2 - current evidence and future challenges
AU - Remon, Jordi
AU - Saw, Stephanie P L
AU - Cortiula, Francesco
AU - Singh, Pawan Kumar
AU - Menis, Jessica
AU - Mountzios, Giannis
AU - Hendriks, Lizza E L
PY - 2024/2
Y1 - 2024/2
N2 - Treatment with 3 years of adjuvant osimertinib is considered a new standard in patients with completely resected stage I to IIIA NSCLC harboring a common sensitizing EGFR mutation. This therapeutic approach significantly prolonged the disease-free survival and the overall survival versus placebo and revealed a significant role in preventing the occurrence of brain metastases. However, many unanswered questions remain, including the optimal duration of this therapy, whether all patients benefit from adjuvant osimertinib, and the role of adjuvant chemotherapy in this population. Indeed, there is a renewed interest in neoadjuvant strategies with targeted therapies in resectable NSCLC harboring oncogenic drivers. In light of these considerations, we discuss the past and current treatment options, and the clinical challenges that should be addressed to optimize the treatment outcomes in this patient population.
AB - Treatment with 3 years of adjuvant osimertinib is considered a new standard in patients with completely resected stage I to IIIA NSCLC harboring a common sensitizing EGFR mutation. This therapeutic approach significantly prolonged the disease-free survival and the overall survival versus placebo and revealed a significant role in preventing the occurrence of brain metastases. However, many unanswered questions remain, including the optimal duration of this therapy, whether all patients benefit from adjuvant osimertinib, and the role of adjuvant chemotherapy in this population. Indeed, there is a renewed interest in neoadjuvant strategies with targeted therapies in resectable NSCLC harboring oncogenic drivers. In light of these considerations, we discuss the past and current treatment options, and the clinical challenges that should be addressed to optimize the treatment outcomes in this patient population.
KW - EGFR-mutant
KW - adjuvant osimertinib
KW - early-stage NSCLC
KW - minimal residual disease
U2 - 10.1016/j.jtho.2023.09.1451
DO - 10.1016/j.jtho.2023.09.1451
M3 - (Systematic) Review article
SN - 1556-0864
VL - 19
SP - 199
EP - 215
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
IS - 2
ER -