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Adjuvant therapy following surgery in non-small cell lung cancer (NSCLC)

Surgery Today volume 46, pages 25–37 (2016)Cite this article

Abstract

Non-small cell lung cancer (NSCLC) accounts for 80–90 % of cases of primary lung cancer. Although surgery is recommended as the primary treatment for early-stage NSCLC, the prognosis is unsatisfactory even when complete resection is achieved. Recent clinical trials have shown that postoperative adjuvant chemotherapy with cytotoxic agents, namely uracil-tegafur (UFT) for stage IA (>2 cm in diameter)-IB patients or cisplatin-based regimens for stage II-IIIA patients, improves the prognosis, and adjuvant chemotherapy is recommended as the “standard treatment of care.” However, adjuvant chemotherapy provides only a modest 5-year survival benefit of 4 % and may sometimes be fatal. To improve the risk–benefit balance of adjuvant chemotherapy, targeting agents such as antibodies against vascular endothelial growth factor (VEGF) and tyrosine-kinase inhibitors of epidermal growth factor receptor (EGFR-TKIs) are being evaluated in ongoing adjuvant trials. Another promising approach may be the individualization of adjuvant chemotherapy based on biomarkers that may predict the prognosis or benefits associated with adjuvant chemotherapy. The current status and future perspectives of adjuvant chemotherapy for NSCLC are reviewed and discussed.

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Conflict of interest

Fumihiro Tanaka received research grant from Taiho Pharmaceutical, Astra Zeneca, Chugai Pharmaceutical, Eli Lilly, and Boehringer Ingelheim. Fumihiro Tanaka received lecture fees from Taiho Pharmaceutical, Astra Zeneca, Chugai Pharmaceutical, Eli Lilly, and Boehringer Ingelheim.

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  1. Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Japan, Iseigaoka 1-1, Yahata-nishi-ku, Kitakyusyu, 807-8555, Japan

    Fumihiro Tanaka & Kazue Yoneda

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Tanaka, F., Yoneda, K. Adjuvant therapy following surgery in non-small cell lung cancer (NSCLC). Surg Today 46, 25–37 (2016). https://doi.org/10.1007/s00595-015-1174-7

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Keywords

  • Non-small cell lung cancer
  • Surgery
  • Adjuvant therapy
  • Biomarker
  • Circulating tumor cell