Both adjuvant and neo-adjuvant chemotherapy are standard-of-care for fit patients, at least for those with resected or resectable stage 2 or 3 non-small cell lung cancer (NSCLC). There is a strong rationale for perioperative immune checkpoint blockade and targeted therapies, such as ALK- and EGFR-directed tyrosine kinase inhibitors (TKIs).
Should we use neoadjuvant chemotherapy, and not upfront surgery in combination with adjuvant treatment of early stage NSCLC? The answer is still not clear. A previous trial showed no statistically significant differences in disease-free survival (DFS) with the addition of preoperative or adjuvant chemotherapy to surgery . In contrast, a recently published analysis of the National Cancer Database showed that both adjuvant and neoadjuvant chemotherapy result in better survival rates than surgery alone in patients with stage 2 or 3 lung cancer .
“The guidelines of the European Society of Thoracic Surgeons (ESTS...
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