Adjuvant immunotherapy of operable non-small cell lung cancer: achievements and treatment prospects

Abstract

Lung cancer is one of the most common malignant tumors with the highest mortality, with about 85% of cases of the disease being non-small cell lung cancer. To date, adjuvant chemotherapy based on platinum preparations remains the standard of treatment for patients with radically operated stage II or III non-small cell lung cancer. However, a large proportion of patients still have a risk of developing a recurrence of lung cancer even after complete resection of the tumor. That is why there is a need to search for new methods of treatment of early stages of NSCLC, which will minimize the likelihood of postoperative relapses and improve survival in a potentially curable group of patients. Already today, clinical trials are beginning to advance the treatment of non-small cell lung cancer in the early stages beyond the standard cytotoxic chemotherapy. Immunotherapy, represented by immune checkpoint inhibitors, is being investigated in an increasing number of clinical trials in patients with operable NSCLC at early stages, gradually enriching existing treatment methods. At the same time, some issues related to adjuvant immunotherapy have yet to be considered. The choice of the drug, the use of monotherapy or combined treatment regimens remain unclear. This review examines the progress of research aimed at improving adjuvant therapy through the inclusion of immune checkpoint inhibitors in the treatment of early stages of resectable non-small cell lung cancer. Adjuvant immunotherapy can improve relapse-free survival in individual patients with resectable lung cancer, and current or planned studies using biomarkers and immunotherapy may also ultimately lead to an improvement in the overall survival of this group of patients.

Keywords

• non-small cell lung cancer
• adjuvant therapy
• immunotherapy
• atezolizumab
• early stage nsclc
• checkpoint inhibitors
• clinical trials