By Jennifer C. King, PhD, Chief Scientific Officer, GO2 for Lung Cancer

Surgery has been the primary treatment for early stage non-small cell lung cancer (NSCLC). Unfortunately, many people have seen their cancer come back after surgery. Now researchers are exploring whether adding therapies currently used to treat advanced lung cancer can improve outcomes in the early stages.

At the 2021 American Society of Clinical Oncology’s Annual Meeting, there were several presentations about NSCLC studies that are looking at adding targeted therapy and immunotherapy to surgery. In some of these studies, new drugs are being added in the adjuvant setting, which means an additional therapy after surgery. In others, they are being studied in the neoadjuvant setting which, means the additional therapy is being added before surgery.

We have learned a lot of important information from these studies:

  • Chemotherapy after surgery (adjuvant) improved outcomes for many patients.
  • Adding chemotherapy plus immunotherapy before surgery (neoadjuvant) did not negatively affect whether patients received surgery.
  • Using an EGFR inhibitor (Tarceva) in the adjuvant setting did not prevent EGFR inhibitors from working again if the cancer recurs later.
  • Adding the immunotherapy Tecentriq (atezolizumab) after surgery and chemotherapy (adjuvant) improved the amount of time before cancer recurs – particularly for patients with Stage II and III lung cancer with the PD-L1 biomarker.

Meanwhile, Tagrisso (osimertinib) was approved by the U.S. Food and Drug Administration in December 2020 as an adjuvant therapy for patients with EGFR positive NSCLC based on its effectiveness in delaying a recurrence of cancer.

Taken together, these studies are providing important new information about how early stage lung cancer can be treated. There are, however, still a lot of unanswered questions. For example, it is not yet clear if adjuvant or neoadjuvant treatments will provide the best outcomes for patients or which therapies will be most effective pre- and post-surgery. As a result, we’re excited to see more research on this topic.