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Review
. 2023 Feb 3;16(2):233.
doi: 10.3390/ph16020233.

Role of Neoadjuvant Immune Checkpoint Inhibitors in Resectable Non-Small Cell Lung Cancer

Ivy Riano  1   2 , Inas Abuali  3 , Aditya Sharma  2   4 , Jewelia Durant  2 , Konstantin H Dragnev  1   2
Affiliations
Review

Role of Neoadjuvant Immune Checkpoint Inhibitors in Resectable Non-Small Cell Lung Cancer

Ivy Riano et al. Pharmaceuticals (Basel). .

Abstract

The neoadjuvant use of immune checkpoint inhibitors (ICI) in resectable non-small cell lung cancer (NSCLC) is being increasingly adopted, but questions about the most appropriate applications remain. Although patients with resectable NSCLC are often treated with surgery and adjuvant chemotherapy or targeted therapies +/- radiotherapy, they still have a high risk of recurrence and death. In recent years, immune checkpoint inhibitors (ICI) (anti-PD-1/PD-L1 and anti-CTLA-4) have provided a new and effective therapeutic strategy for the treatment of advanced NSCLC. Therefore, it is possible that ICIs for early-stage NSCLC may follow the pattern established in metastatic disease. Currently, there are several ongoing trials to determine the efficacy in the neoadjuvant setting for patients with local or regional disease. To date, only nivolumab in combination with chemotherapy has been approved by the U.S. FDA in the preoperative setting, but data continue to evolve rapidly, and treatment guidelines need to be determined. In this article, we review the current preclinical and clinical evidence on neoadjuvant ICIs alone and combination in the treatment of early-stage NSCLC.

Keywords: CTL-4; PD-1; PD-L1; immune checkpoint inhibitors; neoadjuvant treatment; non-small cell lung cancer; resectable lung cancer.

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Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Center for Disease and Control and Prevention An Update on Cancer Deaths in the United States. [(accessed on 18 December 2022)]; Available online: https://www.cdc.gov/cancer/dcpc/research/update-on-cancer-deaths/index.htm.
    1. Goldstraw P., Chansky K., Crowley J., Rami-Porta R., Asamura H., Eberhardt W.E., Nicholson A.G., Groome P., Mitchell A., Bolejack V. The IASLC lung cancer staging project: Proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J. Thorac. Oncol. 2016;11:39–51. doi: 10.1016/j.jtho.2015.09.009. - DOI - PubMed
    1. Liang Y., Wakelee H.A. Adjuvant chemotherapy of completely resected early stage non-small cell lung cancer (NSCLC) Transl. Lung Cancer Res. 2013;2:403–410. doi: 10.3978/j.issn.2218-6751.2013.07.01. - DOI - PMC - PubMed
    1. Ettinger D.S., Wood D.E., Aggarwal C., Aisner D.L., Akerley W., Bauman J.R., Bharat A., Bruno D.S., Chang J.Y., Chirieac L.R. NCCN guidelines insights: Non–small cell lung cancer, version 1.2020: Featured updates to the NCCN guidelines. J. Natl. Compr. Cancer Netw. 2019;17:1464–1472. doi: 10.6004/jnccn.2019.0059. - DOI - PubMed
    1. NSCLC Meta-Analysis Collaborative Group Preoperative chemotherapy for non-small-cell lung cancer: A systematic review and meta-analysis of individual participant data. Lancet. 2014;383:1561–1571. doi: 10.1016/S0140-6736(13)62159-5. - DOI - PMC - PubMed