Neoadjuvant and Adjuvant Therapy for Non–Small Cell Lung Cancer

The use of 4 cycles of cisplatin-based adjuvant chemotherapy is now the standard of care for patients with resected stage II and IIIA non–small cell lung cancer. Neoadjuvant chemotherapy lacks the same level of data as adjuvant treatment, but meta-analyses of this approach support its use. Selection of patients who are most likely to benefit from chemotherapy remain elusive. Ongoing adjuvant trials are exploring biomarkers, molecularly targeted agents, postoperative radiation therapy, and immunotherapy.

Key points

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The use of 4 cycles of cisplatin-based adjuvant chemotherapy is the standard of care for patients with resected stage II and IIIA non–small cell lung cancer.
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Neoadjuvant chemotherapy can also be considered but lacks the same level of data as adjuvant treatment.
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Good methods for selection of patients who are most likely to benefit from chemotherapy have yet to be determined.
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Ongoing adjuvant trials are exploring biomarkers of chemotherapy benefit, molecularly targeted agents, postoperative radiation therapy, and immunotherapy agents.