Adjuvant therapy in non-small cell lung cancer: Current status and future perspectives
The efficacy of postoperative adjuvant chemotherapy for patients with completely resected NSCLC has been elucidated in several large randomized trials. A meta-analysis of five of the recently performed cisplatin-based chemotherapy trials, the Lung Adjuvant Cisplatin Evaluation (LACE) meta-analysis, confirmed that adjuvant cisplatin-based chemotherapy improves survival of patients with completely resected NSCLC. Thus, cisplatin-based adjuvant chemotherapy is now considered as the standard of care for patients with completely resected NSCLC stage, II–III. According to the LACE meta-analysis, patients with stage IA NSCLC should not receive adjuvant chemotherapy but it could be considered for selected patients with stage IB disease. Because the overall benefit of adjuvant chemotherapy is small, new treatment strategies including customized chemotherapy, integration of molecular-targeted therapies, and immunotherapy are under investigation and may show better results in patients with completely resected early-stage NSCLC.