J.Jpn. Surg. Soc.. 125(4): 340-347, 2024

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Feature topic

PERIOPERATIVE CARE OF NON-SMALL CELL LUNG CANCER: NOW AND IN THE FUTURE

Resectable non-small cell lung cancer (NSCLC) has a poor prognosis, with some patients developing distant metastatic recurrence even at stage I. Therefore, perioperative therapy was developed, with the immune checkpoint inhibitor (ICI) atezolizumab and the epidermal growth factor receptor inhibitor osimertinib approved for adjuvant therapy and chemotherapy plus the ICI nivolumab for preoperative therapy. However, there are still various problems in its introduction into clinical practice. Further development of pre- and postoperative therapies is underway, and treatment options in perioperative care are expected to increase in the future. There is much debate as to whether preoperative or postoperative treatment is better, but the issue has not been settled and there are no clear criteria for patient selection. Although safety is strongly required since some patients undergoing perioperative chemotherapy will be cured without treatment, promising efficacy is needed since they are a curative population. Hence patient selection is a pressing issue. This article describes the currently approved therapies and clinical questions, as well as new therapies that are currently being reported, considerations for patient selection, and strengthening of immunotherapy.

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