Elsevier

Journal of Thoracic Oncology

Volume 13, Issue 12, December 2018, Pages 1818-1831
Journal of Thoracic Oncology

Review Article
Current Status and Future Perspectives on Neoadjuvant Therapy in Lung Cancer

https://doi.org/10.1016/j.jtho.2018.09.017Get rights and content
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Abstract

This Review Article provides a multi-stakeholder view on the current status of neoadjuvant therapy in lung cancer. Given the success of oncogene-targeted therapy and immunotherapy for patients with advanced lung cancer, there is a renewed interest in studying these agents in earlier disease settings with the opportunity to have an even greater impact on patient outcomes. There are unique opportunities and challenges with the neoadjuvant approach to drug development. To achieve more rapid knowledge turns, study designs, endpoints, and definitions of pathologic response should be standardized and harmonized. Continued dialogue with all stakeholders will be critical to design and test novel induction strategies, which could expedite drug development for patients with early lung cancer who are at high risk for metastatic recurrence.

Keywords

Neoadjuvant therapy
Induction chemotherapy
Resectable lung cancer
Pathologic response
Preoperative therapy

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Disclosure: Dr. Bunn has received grants from Bristol-Myers Squibb; and has received personal fees from Astra Zeneca, Bristol-Myers Squibb, Genentech, Merck, Merck-Serono, Lilly, and Takeda. Dr. Chaft has received grants from Bristol-Myers Squibb; and has received personal fees from Bristol-Myers Squibb, Genentech, Merck, and Astra Zeneca. Dr. McCoach has received personal fees from Takeda and Guardant Health. Dr. Perez was an employee of Genentech until May 2018. Dr. Scagliotti has received personal fees from Eli Lilly, Roche, Astra Zeneca, Pfizer, Abbvie, and MSD. Dr. Carbone has received personal fees from Abbvie, Adaptimmune, Agenus, Amgen, Astra Zeneca, Biocept, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Clovis, EMD Serono, Inc., Foundation Medicine, Genentech/Roche, Gritstone, Guardant Health, Helsinn, Inivata, Inovio, Janssen, Merck, Merck Sharp Dohme, Novartis, Palobiofarma, Pfizer, prIME Oncology, Stemcentrx, Takeda, and Teva. Dr. Aisner has received personal fees from Genentech, Bristol-Myers Squibb, and Abbvie. Dr. Bergh has received grants from Amgen, Astra Zeneca, Bayer, Merck, Pfizer, Roche, and Sanofi-Avantis. Dr. Berry is co-owner and consultant for Berry Consultants, LLC. Dr. Jarkowski is employed by and owns stock with Bristol-Myers Squibb. Dr. Botwood is an employee with Bristol-Myers Squibb. Dr. Diehn is the founder of CiberMed; has received grants from Varian Medical Systems; has received personal fees from Roche, Quanticel, and Astra Zeneca; and has a paten with Roche on cancer biomarkers. Dr. Doebele is co-founder for Rain Therapeutics; has received grants from Ignyta; has received personal fees from Pfizer, Astra Zeneca, Ariad, Takeda, Guardant Health, Spectrum Pharmaceuticals, Ignyta, OncoMed, Trovagene, Bayer; and has patents pending with Rain Therapeutics and Abbott Molecular. Dr. Blakely has received grants from Astra Zeneca and Novartis. Dr. Eberhardt has received grants from Eli Lilly and Bristol-Myers Squibb; and has received personal fees from Astra Zeneca, Bristol-Myers Squibb, Roche, Pfizer, Boehringer Ingelheim, Novartis, Celgene, Takeda, Abbvie, Amgen, Bayer, and Daiichi-Sankyo. Dr. Felip has consulted with Astra Zeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Guardant Health, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Takeda, Abbvie, and Merck. Dr. Keller is an employee with Merck. Dr. Rizvi is co-founder and shareholder with Gristone Oncology; has received personal fees from Astra Zeneca, Abbvie, Bristol-Myers Squibb, Eli Lilly, Merck, Merck KGaA, Novartis, Pfizer, Regeneron, Roche, ARMO BioSciences, and Neogenomics; and has a patent pending with MSKCC. Dr. Rusch has received grants from Genelux, Inc. Dr. DeRuysscher has received grants from Bristol-Myers Squibb, Roche/Genentech, Celgene, and Merck/Pfizer. Dr. Schwartz has received research support from Merck and Novartis. Dr. Taube has received grants from Bristol-Myers Squibb; and is on advisory boards with Bristol-Myers Squibb, Merck, Astra Zeneca, and Amgen. Dr. Travis has been a nonpaid consultant with Genentech. Dr. Wistuba has received grants from Genentech/Roche, Medimmune/Astra Zeneca, Bristol-Myers Squibb, Pfizer, HTG Molecular, Asuragen, Merck, Adaptive, Adaptimmune, EMD Serono, Takeda, Amgen, and Karus; and has received personal fees from Genentech/Roche, Medimmune/Astra Zeneca, Bristol-Myers Squibb, Bayer, Boehringer Ingelheim, Pfizer, HTG Molecular, Asuragen, Merck, and GSK. Dr. Hirsch is on advisory boards with Abbvie, Astra Zeneca, Biocept, Bristol-Myers Squibb, HTG, Lilly, Loxo, Merck, Novartis, Pfizer, Roche/Genentech, and Ventana; and has a patent with Abbott Molecular through the University of Colorado. Dr. Kris has received grants from Free to Breathe; and has received personal fees from Astra Zeneca, Pfizer, and Regeneron. The remaining authors declare no conflict of interest.