Abstract
Antitumor immunotherapy using checkpoint inhibitors brings significant improvement in treatment outcomes for patients with stage III non-small cell lung cancer (NSCLC). In the case of approximately 20-25% of operable tumors, neoadjuvant chemoimmunotherapy leads to a several-fold increase in the frequency of major or complete pathological tumor regressions in the resected specimens compared to chemotherapy alone.
A significant prolongation of the time to disease progression was also demonstrated. Adjuvant immunotherapy also significantly increased time to progression compared to placebo after surgery and chemotherapy, especially in high programmed cell death-ligand 1 (PD-L1) expressors.
Both perioperative modalities expect registration as standard procedure. In the case of inoperable stage III, consolidation treatment with immunotherapy is the standard with a doubling of long-term survival.
Adjuvant osimertinib targeted therapy in operated epidermal growth factor receptor (EGFR) mutated NSCLC is the first indication of this kind in non-metastatic disease. The benefit of postoperative radiotherapy in patients with involvement of the mediastinal nodes is questioned according to the latest published results.