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Background <p>Systemic treatment of resectable non-small cell lung cancer (NSCLC) has changed fundamentally with the integration of immunotherapy.</p> Objective <p>To summarize the current role of neoadjuvant and perioperative treatment strategies in resectable NSCLC.</p> Material and methods <p>Narrative review of current phase&#xa0;III data, guideline recommendations and clinically relevant aspects of interdisciplinary treatment decisions.</p> Results <p>In patients without treatment-deciding epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) alterations, the standard of care has increasingly shifted from purely adjuvant strategies towards neoadjuvant and perioperative approaches. The combination of platinum-based chemotherapy and immune checkpoint inhibition improves pathological response rates and event-free survival; overall survival benefits have also been demonstrated for selected regimens. A prerequisite for safe implementation is an early molecular testing and interdisciplinary assessment of resectability, functional operability, tumor stage, recurrence risk and acceptance of toxicity. Biomarkers such as programmed death-ligand&#xa0;1 (PD-L1) expression, pathological response and, in the future, circulating tumor DNA can refine risk stratification but do not replace integrated clinical judgment.</p> Conclusion <p>Neoadjuvant and perioperative chemoimmunotherapy have become central components of modern treatment for resectable NSCLC. Careful selection of suitable patients in an experienced multidisciplinary tumor board remains essential.</p>

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Perioperative Therapie des operablen nicht-kleinzelligen Lungenkarzinoms

  • 期刊论文

  • 发表日期：

    2026年8月3日

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  • Michelle Thieser,
  • Frank Langer,
  • Cornelia Kropf-Sanchen,
  • Jan A. Stratmann

摘要

Background

Systemic treatment of resectable non-small cell lung cancer (NSCLC) has changed fundamentally with the integration of immunotherapy.

Objective

To summarize the current role of neoadjuvant and perioperative treatment strategies in resectable NSCLC.

Material and methods

Narrative review of current phase III data, guideline recommendations and clinically relevant aspects of interdisciplinary treatment decisions.

Results

In patients without treatment-deciding epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) alterations, the standard of care has increasingly shifted from purely adjuvant strategies towards neoadjuvant and perioperative approaches. The combination of platinum-based chemotherapy and immune checkpoint inhibition improves pathological response rates and event-free survival; overall survival benefits have also been demonstrated for selected regimens. A prerequisite for safe implementation is an early molecular testing and interdisciplinary assessment of resectability, functional operability, tumor stage, recurrence risk and acceptance of toxicity. Biomarkers such as programmed death-ligand 1 (PD-L1) expression, pathological response and, in the future, circulating tumor DNA can refine risk stratification but do not replace integrated clinical judgment.

Conclusion

Neoadjuvant and perioperative chemoimmunotherapy have become central components of modern treatment for resectable NSCLC. Careful selection of suitable patients in an experienced multidisciplinary tumor board remains essential.