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Published online: 2024-06-24

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Advancements in non-small cell lung cancer treatment: from early to advanced stages

Adam Płużański1, Aleksandra Piórek1

Abstract

Over the past years, tremendous progress has been made in the treatment available for non-small cell lung cancer patients (NSCLC), both in the early and advanced stages of the disease. In early-stage NSCLC, perioperative immunotherapy is emerging as a promising approach. Several studies in preoperative chemoimmunotherapy showed a significant increase in the rate of complete pathologic response and prolonged event-free survival in resectable NSCLC patients. Similarly, atezolizumab and osimertinib are the standard of care in some patients after complete resection in EGFR-mutated or programmed cell death ligand 1 (PD-L1) high-expressing tumors. In locally advanced disease, durvalumab consolidation therapy following chemoradiotherapy improved progression-free survival (PFS) and overall survival (OS) in unresectable NSCLC while other immunotherapies in combination with chemotherapy showed promising results. In advanced NSCLC, novel immunotherapies or immunoconjugates such as trastuzumab deruxtecan are also demonstrating efficacy. Furthermore, molecularly targeted therapy targeting KRAS, EGFR, and other genetic aberrations, guided by next-generation sequencing, offers new treatment options. However, challenges remain, including patient selection, sequencing, and reimbursement. This article reviews the latest treatments for patients with NSCLC in the early and advanced stages of the disease.

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