Sequencing Systemic Therapy in Resectable NSCLC: Equipoise Remains

Background Information

New trials may refine lung cancer therapy timing strategies.

Targeted therapies and immunotherapies are advancing treatment options for resectable non-small cell lung cancer (NSCLC), potentially improving surgical outcomes. FDA approved osimertinib and alectinib for adjuvant treatment in resected stage II/III EGFR and ALK-mutated NSCLC, while chemotherapy and immune checkpoint inhibitors are now standard in multiple settings. The ongoing trials (PROSPECT-Lung and INSIGHT) aim to refine the timing of therapy, addressing whether adjuvant or neoadjuvant chemoimmunotherapy is more effective and the benefit of adjuvant immunotherapy after a complete response. Optimal timing of immunotherapy and targeted therapy in NSCLC is under investigation, with major implications for treatment strategies.