Neoadjuvant/Perioperative Immunotherapy in NSCLC

EP: 1.Treatment Approaches for Early-Stage Lung Cancer

EP: 2.Driving Precision Medicine Through Molecular Testing in NSCLC

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EP: 3.Neoadjuvant/Perioperative Immunotherapy in NSCLC

EP: 4.Referral of Early-Stage NSCLC to Multidisciplinary Teams

EP: 5.Neoadjuvant, Adjuvant, and Perioperative Options in NSCLC

EP: 6.Updates in CheckMate-816 From ESMO 2023

EP: 7.AEGEAN Trial: Perioperative Approach in NSCLC

EP: 8.Latest From the NEOTORCH Trial & KEYNOTE-671 Trial

EP: 9.CheckMate-77T Trial Results From ESMO 2023

EP: 10.Treatment Decision Making by Stage for Resectable NSCLC

EP: 11.The Emerging Role of ctDNA in NSCLC Management

EP: 12.Addressing Gaps in Care for Non-Small Cell Lung Cancer

This is a video synopsis/summary of a Precision Medicine featuring Patrick Forde, MBBCh, and Tina Cascone, MD, PhD.

Forde and Cascone discuss the role of neoadjuvant and perioperative immunotherapy in subgroups of patients with actionable genomic alterations in resectable non–small cell lung cancer (NSCLC). In advanced disease, certain genomic alterations, such as EGFR, ALK, ROS1, and RET, derive much less benefit from immunotherapy. However, there are some alterations, like BRAF V600E and KRAS G12C, where there is equipoise between targeted therapy and immunotherapy.

In early-stage disease, there is limited data on the benefit of immunotherapy in patients with actionable genomic alterations, as they were largely excluded from neoadjuvant or perioperative trials. However, phase 3 data supports the use of adjuvant targeted therapy in patients with EGFR (ADAURA trial) or ALK (ALINA trial) alterations. Therefore, patients should be tested for EGFR and ALK alterations in the preoperative setting and, if positive, be excluded from preoperative immunotherapy and instead receive adjuvant chemotherapy followed by targeted therapy. This approach also avoids potential toxicity from the interplay between immunotherapy and targeted therapy.

Video synopsis is AI-generated and reviewed by Targeted Oncology™ editorial staff.