Perioperative Therapy in Oncogene-Driven NSCLC: Current Strategies and Unanswered Questions
Adjuvant osimertinib significantly improves disease‑free survival and overall survival in resected EGFR‑mutated non‑small cell lung cancer, providing a durable benefit that persists beyond the three‑year treatment period.
This chapter reviews perioperative treatment options for oncogene‑driven non‑small cell lung cancer (NSCLC), focusing on EGFR‑mutated disease. It summarizes the evolution of adjuvant and neoadjuvant targeted therapy and immunotherapy, highlights key trials such as EVAN, ADJUVANT, RADIANT, and particularly the phase‑III ADAURA study that established osimertinib as standard adjuvant therapy. The discussion includes challenges in molecular testing, the role of rapid turnaround assays, and ongoing trials exploring combinations of targeted therapy and chemotherapy, including NeoADAURA.
Improving long‑term outcomes in early‑stage EGFR‑mutated NSCLC is critical, as surgical resection alone offers limited cure rates. Adjuvant osimertinib has demonstrated a major disease‑free survival benefit, reshaping standard of care and providing patients with a durable, CNS‑penetrant therapy that continues to impact survival years beyond treatment completion.
Evidence level: Számítógépes vagy elméleti. Modellből vagy adatbányászatból származó jel.
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