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Expert Rev Anticancer Ther. 2018 Jan;18(1):63-70. doi: 10.1080/14737140.2018.1409624. Epub 2017 Nov 26.

Role of chemotherapy and targeted therapy in early-stage non-small cell lung cancer.

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a Department of Oncology , Karmanos Cancer Institute/Wayne State University , Detroit , MI , USA.
b Department of Advanced Medical Innovation , St. Marianna University Graduate School of Medicine, Kawasaki , Kanagawa , JAPAN.
c Department of Internal Medicine, Division of Hematology/Oncology , University of Michigan , Ann Arbor , MI , USA.


Adjuvant platinum based chemotherapy is accepted as standard of care in stage II and III non-small cell lung cancer (NSCLC) patients and is often considered in patients with stage IB disease who have tumors ≥ 4 cm. The survival advantage is modest with approximately 5% at 5 years. Areas covered: This review article presents relevant data regarding chemotherapy use in the perioperative setting for early stage NSCLC. A literature search was performed utilizing PubMed as well as clinical Randomized phase III studies in this setting including adjuvant and neoadjuvant use of chemotherapy as well as ongoing trials on targeted therapy and immunotherapy are also discussed. Expert commentary: With increasing utilization of screening computed tomography scans, it is possible that the percentage of early stage NSCLC patients will increase in the coming years. Benefits of adjuvant chemotherapy in early stage NSCLC patients remain modest. There is a need to better define patients most likely to derive survival benefit from adjuvant therapy and spare patients who do not need adjuvant chemotherapy due to the toxicity of such therapy. Trials for adjuvant targeted therapy, including adjuvant EGFR-TKI trials and trials of immunotherapy drugs are ongoing and will define the role of these agents as adjuvant therapy.


Non-small-cell lung cancer; adjuvant chemotherapy; adjuvant immunotherapy; adjuvant targeted therapy; early-stage; neoadjuvant chemotherapy

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