Q&A: Perioperative immunotherapy advances for early-stage NSCLC

Editor's Note

Perioperative immunotherapy is reshaping treatment strategies for early-stage non-small cell lung cancer (NSCLC) without actionable mutations, according to Dr. Roy S. Herbst of Yale Cancer Center. In a recent interview with OncLive, the oncology expert highlighted the promise of neoadjuvant and adjuvant therapies to improve outcomes for these patients and addressed ongoing research needs.

Published December 4, the Q&A delves into trial results showing an overall survival benefit from neoadjuvant pembrolizumab (Keytruda) with chemotherapy followed by adjuvant pembrolizumab. However, selecting the right patients is critical, Dr Herbst says. Additionally, data show adjuvant pembrolizumab provides an option for patients who undergo surgery without prior neoadjuvant therapy, and that atezolizumab (Tecentriq) is approved as adjuvant therapy for certain patients.

According to Dr Herbst, whether to to administer neoadjuvant therapy, adjuvant therapy, or both remains a critical question. while neoadjuvant therapy is preferable for many, it requires careful selection to avoid delays in surgery or rendering tumors unresectable. For patients achieving a pCR after neoadjuvant therapy, continuing immunotherapy post-surgery could be beneficial. Further study is needed.

The full Q&A provides additional context on specific trial results, what kinds of research is needed in future studies, patient selection criteria, and more.