Perioperative therapy for non-small cell lung cancer – Current status and future perspective –
Lung cancer is the leading cause of cancer-related death. Surgery has been playing a pivotal role in the treatments with curative intent for non-small cell lung cancer (NSCLC). However, the outcome after surgery alone remains unsatisfactory. During the last two decades, several attempts have been made to improve the postoperative outcome. Meta-analysis demonstrated that adjuvant cisplatin-based chemotherapy achieved 4-5% of benefit in the 5-year survival as compared to surgery alone. Preoperative induction chemotherapy also yielded a 5% improvement of the 5-year survival rate, showing a similar efficacy with adjuvant chemotherapy. Induction chemoradiotherapy enhanced local control, whereas it was not associated with any survival benefit. Recently, the development of new drugs, such as tyrosine kinase inhibitors and immune checkpoint inhibitors, represents a major treatment advance for patients with lung cancer. Several attempts have been made to apply these drugs to perioperative treatments. In this review, we sought to summarize the developments of perioperative therapy in the treatments of NSCLC, and discuss the future perspectives.
