Adjuvan or Neoadjuvan Immunotherapy for Non-Small Cell Lung Carcinoma

Yusuf İLHANa , Ali Murat TATLIb
aAntalya City Hospital, Clinic of Medical Oncology, Antalya, Türkiye
bAkdeniz University Faculty of Medicine, Department of Medical Oncology, Antalya, Türkiye

İlhan Y, Tatlı AM. Adjuvan or neoadjuvan immunotherapy for non-small cell lung carcinoma. In: Şendur MAN, ed. Current Immunotherapy Landscape for Solid Tumors. 1st ed. Ankara: Türkiye Klinikleri; 2024. p.38- 43.

ABSTRACT
Non-small cell lung cancer, which is among the most common cancers in both sexes, remains a significant cause of morbidity and mortality worldwide. Surgical resection is the main treatment in early-stage disease; however, despite effective surgery in early stages, high rates of recurrence can still occur. The use of platinum-based chemotherapy combinations in the adjuvant setting improves survival outcomes, but significant advancements are still needed in this area. Immunotherapies have increasingly become a routine part of our treatment approaches, particularly in metastatic lung cancer and many other solid tumors. In cases of early-stage non-small cell lung cancer, there is a growing body of knowledge and important developments regarding the use of immunotherapy agents in both adjuvant and neoadjuvant settings. This chapter will provide an overview of adjuvant and neoadjuvant immunotherapy approaches in patients with non-small cell lung cancer.

Keywords: Adjuvan immunotherapy; non-small cell lung cancer; neoadjuvan immunotherapy; lung neoplasms

Referanslar

  1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7-33. [Crossref]  [PubMed]
  2. Sun H, Jin C, Wang H, Hu S, Chen Y, Wang H. Cost-effectiveness of stereotactic body radiotherapy in the treatment of non-small-cell lung cancer (NSCLC): a systematic review. Expert Rev Pharmacoecon Outcomes Res. 2022;22(5):723-34. [Crossref]  [PubMed]
  3. Molina JR, Yang P, Cassivi SD, Schild SE, Adjei AA. Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin Proc. 2008;83(5):584-94. [Crossref]  [PubMed]  [PMC]
  4. Shao L, Lou G. Neoadjuvant immunotherapy in non-small cell lung cancer: a narrative review on mechanisms, efficacy and safety. J Thorac Dis. 2022; 14(9):3565-74. [Crossref]  [PubMed]  [PMC]
  5. Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, et al. 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(1):39-51. [Crossref]  [PubMed]
  6. Felip E, Altorki N, Zhou C, Csőszi T, Vynnychenko I, Goloborodko O, et al. Adjuvant atezolizumab after adjuvant chemotherapy in resected stage IB-IIIA non-small-cell lung cancer (IMpower010): a randomised, multicentre, open-label, phase 3 trial. Lancet. 2021;398(10308):1344-57. Erratum in: Lancet. 2021 Sep 23;: [Crossref]  [PubMed]
  7. O'Brien M, Paz-Ares L, Marreaud S, Dafni U, Oselin K, Havel L, et al. Pembrolizumab versus placebo as adjuvant therapy for completely resected stage IB-IIIA non-small-cell lung cancer (PEARLS/KEYNOTE-091): an interim analysis of a randomised, triple-blind, phase 3 trial. Lancet Oncol. 2022;23(10):1274-86. [Crossref]  [PubMed]
  8. Food and Drug Administration website. [cited: June 19, 2023]. Available from: [Link]
  9. Food and Drug Administration website. [cited: June 19, 2023]. Available from: [Link]
  10. Nivolumab After Surgery and Chemotherapy in Treating Patients With Stage IB-IIIA Non-small Cell Lung Cancer (An ALCHEMIST Treatment Trial) (ANVIL). [cited: May 17, 2023]. Available from: [Link]
  11. Double Blind Placebo Controlled Controlled Study of Adjuvant MEDI4736 In Completely Resected NSCLC. [cited: May 17, 2023]. Available from: [Link]
  12. New Adjuvant Trial of Chemotherapy vs Chemo-immunotherapy (NADIM-ADJUVANT). [cited: May 17, 2023]. Available from: [Link]
  13. Pisters KM, Vallières E, Crowley JJ, Franklin WA, Bunn PA Jr, Ginsberg RJ, et al. Surgery with or without preoperative paclitaxel and carboplatin in early-stage non-small-cell lung cancer: Southwest Oncology Group Trial S9900, an intergroup, randomized, phase III trial. J Clin Oncol. 2010;28(11):1843-9. [Crossref]  [PubMed]  [PMC]
  14. Scagliotti GV, Pastorino U, Vansteenkiste JF, Spaggiari L, Facciolo F, Orlowski TM, et al. Randomized phase III study of surgery alone or surgery plus preoperative cisplatin and gemcitabine in stages IB to IIIA non-small-cell lung cancer. J Clin Oncol. 2012;30(2):172-8. [Crossref]  [PubMed]
  15. Blank CU, Rozeman EA, Fanchi LF, Sikorska K, van de Wiel B, Kvistborg P, et al. Neoadjuvant versus adjuvant ipilimumab plus nivolumab in macroscopic stage III melanoma. Nat Med. 2018;24(11):1655-61. [Crossref]  [PubMed]
  16. Chaft JE, Rusch V, Ginsberg MS, Paik PK, Finley DJ, Kris MG, et al. Phase II trial of neoadjuvant bevacizumab plus chemotherapy and adjuvant bevacizumab in patients with resectable nonsquamous non-small-cell lung cancers. J Thorac Oncol. 2013;8(8):1084-90. [Crossref]  [PubMed]  [PMC]
  17. Pataer A, Kalhor N, Correa AM, Raso MG, Erasmus JJ, Kim ES, et al.; University of Texas M. D. Anderson Lung Cancer Collaborative Research Group. Histopathologic response criteria predict survival of patients with resected lung cancer after neoadjuvant chemotherapy. J Thorac Oncol. 2012;7(5):825-32. [Crossref]  [PubMed]  [PMC]
  18. Cascone T, Gold KA, Swisher SG, Liu DD, Fossella FV, Sepesi B, et al. Induction Cisplatin Docetaxel Followed by Surgery and Erlotinib in Non-Small Cell Lung Cancer. Ann Thorac Surg. 2018;105(2):418-24. [Crossref]  [PubMed]  [PMC]
  19. Cascone T, William WN Jr, Weissferdt A, Leung CH, Lin HY, Pataer A, et al. Neoadjuvant nivolumab or nivolumab plus ipilimumab in operable non-small cell lung cancer: the phase 2 randomized NEOSTAR trial. Nat Med. 2021;27(3):504-14. [Crossref]  [PubMed]  [PMC]
  20. Forde PM, Spicer J, Lu S, Provencio M, Mitsudomi T, Awad MM, et al. Neoadjuvant Nivolumab plus Chemotherapy in Resectable Lung Cancer. N Engl J Med. 2022;386(21):1973-85. [Crossref]  [PubMed]  [PMC]
  21. Chaft JE, Oezkan F, Kris MG, Bunn PA, Wistuba II, Kwiatkowski DJ, et al. Neoadjuvant atezolizumab for resectable non-small cell lung cancer: an open-label, single-arm phase II trial. Nat Med. 2022;28(10):2155-61. Erratum in: Nat Med. 2024;30(1):303. [Crossref]  [PubMed]  [PMC]
  22. Provencio M, Nadal E, Insa A, García-Campelo MR, Casal-Rubio J, Dómine M, et al. Neoadjuvant chemotherapy and nivolumab in resectable non-small-cell lung cancer (NADIM): an open-label, multicentre, single-arm, phase 2 trial. Lancet Oncol. 2020;21(11):1413-22. [Crossref]  [PubMed]
  23. Rothschild SI, Zippelius A, Eboulet EI, Savic Prince S, Betticher D, Bettini A, et al.; Swiss Group for Clinical Cancer Research (SAKK). SAKK 16/14: Durvalumab in Addition to Neoadjuvant Chemotherapy in Patients With Stage IIIA(N2) Non-Small-Cell Lung Cancer-A Multicenter Single-Arm Phase II Trial. J Clin Oncol. 2021;39(26):2872-80. [Crossref]  [PubMed]
  24. Wakelee H, Liberman M, Kato T, Tsuboi M, Lee SH, Gao S, et al.; KEYNOTE-671 Investigators. Perioperative Pembrolizumab for Early-Stage Non-Small-Cell Lung Cancer. N Engl J Med. 2023;389(6):491-503. [Crossref]  [PubMed]  [PMC]
  25. Food and Drug Administration website. [cited: June 19, 2023]. Available from: [Link]
  26. Bristol Myers Squibb receives European Commission approval for Opdivo (nivolumab) with chemotherapy as neoadjuvant treatment of resectable non-small cell lung cancer at high risk of recurrence in patients with tumor cell PD-L1 expression ≥1%. News release. Bristol Myers Squibb. [cited: July 10, 2023]. Available from: [Link]