Perioperative treatment strategies in EGFR-mutant early-stage NSCLC: current evidence and future challenges

Jordi Remon*, Stephanie P L Saw, Francesco Cortiula, Pawan Kumar Singh, Jessica Menis, Giannis Mountzios, Lizza E L Hendriks

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

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Abstract

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.

Original languageEnglish
Pages (from-to)199-215
Number of pages17
JournalJournal of Thoracic Oncology
Volume19
Issue number2
Early online date30 Sept 2023
DOIs
Publication statusPublished - Feb 2024

Keywords

  • EGFR-mutant
  • adjuvant osimertinib
  • early-stage NSCLC
  • minimal residual disease

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