Perioperative Chemo/Immunotherapies in Lung Cancer: A Critical Review on the Value of Perioperative Sequences
Resectable non-small cell lung cancer (NSCLC) continues to pose significant challenges with high recurrence and mortality rates, despite traditional platinum-based chemotherapy yielding only an approximate 5% improvement in 5-year overall survival when administered preoperatively or postoperatively....
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MDPI AG
2025-07-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/32/7/397 |
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| author | Thoma’ Dario Clementi Francesca Colonese Stefania Canova Maria Ida Abbate Luca Sala Francesco Petrella Gabriele Giuseppe Pagliari Diego Luigi Cortinovis |
| author_facet | Thoma’ Dario Clementi Francesca Colonese Stefania Canova Maria Ida Abbate Luca Sala Francesco Petrella Gabriele Giuseppe Pagliari Diego Luigi Cortinovis |
| author_sort | Thoma’ Dario Clementi |
| collection | DOAJ |
| description | Resectable non-small cell lung cancer (NSCLC) continues to pose significant challenges with high recurrence and mortality rates, despite traditional platinum-based chemotherapy yielding only an approximate 5% improvement in 5-year overall survival when administered preoperatively or postoperatively. In recent years, the integration of immune checkpoint inhibitors (ICIs), such as nivolumab, durvalumab and pembrolizumab, with platinum-based regimens in the perioperative setting has emerged as a transformative strategy. Our comprehensive review, based on a systematic bibliographic search of PubMed, Google Scholar, EMBASE, Cochrane Library, and clinicaltrials.gov, targeting pivotal clinical trials from the past two decades, examines the impact of these neoadjuvant and adjuvant chemoimmunotherapy approaches on major pathological response rates and overall survival in early-stage NSCLC. Although these perioperative strategies represent a paradigm shift in treatment, promising durable responses are offset by persistent recurrence, emphasizing the necessity for optimized treatment sequencing, duration, and the identification of predictive biomarkers. Collectively, our findings underscore the critical role of the perioperative schema, particularly the neoadjuvant component, which enables the evaluation of novel biomarkers as surrogates for overall survival, in improving patient outcomes and delineating future research directions aimed at reducing mortality and enhancing the quality of life for patients with resectable NSCLC. |
| format | Article |
| id | doaj-art-370a511d35e94bc99ea5c4ce9751bcd0 |
| institution | DOAJ |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj-art-370a511d35e94bc99ea5c4ce9751bcd02025-08-20T02:45:34ZengMDPI AGCurrent Oncology1198-00521718-77292025-07-0132739710.3390/curroncol32070397Perioperative Chemo/Immunotherapies in Lung Cancer: A Critical Review on the Value of Perioperative SequencesThoma’ Dario Clementi0Francesca Colonese1Stefania Canova2Maria Ida Abbate3Luca Sala4Francesco Petrella5Gabriele Giuseppe Pagliari6Diego Luigi Cortinovis7Medical Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, ItalyMedical Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, ItalyMedical Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, ItalyMedical Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, ItalyMedical Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, ItalyDepartment of Thoracic Surgery, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, ItalyMedical Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, ItalyMedical Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, ItalyResectable non-small cell lung cancer (NSCLC) continues to pose significant challenges with high recurrence and mortality rates, despite traditional platinum-based chemotherapy yielding only an approximate 5% improvement in 5-year overall survival when administered preoperatively or postoperatively. In recent years, the integration of immune checkpoint inhibitors (ICIs), such as nivolumab, durvalumab and pembrolizumab, with platinum-based regimens in the perioperative setting has emerged as a transformative strategy. Our comprehensive review, based on a systematic bibliographic search of PubMed, Google Scholar, EMBASE, Cochrane Library, and clinicaltrials.gov, targeting pivotal clinical trials from the past two decades, examines the impact of these neoadjuvant and adjuvant chemoimmunotherapy approaches on major pathological response rates and overall survival in early-stage NSCLC. Although these perioperative strategies represent a paradigm shift in treatment, promising durable responses are offset by persistent recurrence, emphasizing the necessity for optimized treatment sequencing, duration, and the identification of predictive biomarkers. Collectively, our findings underscore the critical role of the perioperative schema, particularly the neoadjuvant component, which enables the evaluation of novel biomarkers as surrogates for overall survival, in improving patient outcomes and delineating future research directions aimed at reducing mortality and enhancing the quality of life for patients with resectable NSCLC.https://www.mdpi.com/1718-7729/32/7/397perioperative in lung cancerresectable/early-stage NSCLCchemo-immunotherapies for NSCLCneoadjuvant ICIs |
| spellingShingle | Thoma’ Dario Clementi Francesca Colonese Stefania Canova Maria Ida Abbate Luca Sala Francesco Petrella Gabriele Giuseppe Pagliari Diego Luigi Cortinovis Perioperative Chemo/Immunotherapies in Lung Cancer: A Critical Review on the Value of Perioperative Sequences Current Oncology perioperative in lung cancer resectable/early-stage NSCLC chemo-immunotherapies for NSCLC neoadjuvant ICIs |
| title | Perioperative Chemo/Immunotherapies in Lung Cancer: A Critical Review on the Value of Perioperative Sequences |
| title_full | Perioperative Chemo/Immunotherapies in Lung Cancer: A Critical Review on the Value of Perioperative Sequences |
| title_fullStr | Perioperative Chemo/Immunotherapies in Lung Cancer: A Critical Review on the Value of Perioperative Sequences |
| title_full_unstemmed | Perioperative Chemo/Immunotherapies in Lung Cancer: A Critical Review on the Value of Perioperative Sequences |
| title_short | Perioperative Chemo/Immunotherapies in Lung Cancer: A Critical Review on the Value of Perioperative Sequences |
| title_sort | perioperative chemo immunotherapies in lung cancer a critical review on the value of perioperative sequences |
| topic | perioperative in lung cancer resectable/early-stage NSCLC chemo-immunotherapies for NSCLC neoadjuvant ICIs |
| url | https://www.mdpi.com/1718-7729/32/7/397 |
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