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1 ESMO - MORA point
- To understand the potential of perioperative treatments
- To identify patients who should receive perioperative treatment for NSCLC
- To choose the most appropriate perioperative treatment
- To know the modalities of delivery for perioperative treatments
In this E-Learning module, the author reviews and puts into practice perspective the data on perioperative treatment for non-small cell lung cancer (NSCLC). In particular, perioperative chemotherapy, preoperative chemoradiation, perioperative targeted treatments, perioperative immunotherapy, and postoperative mediastinal radiotherapy are elaborated.
Each of the treatment modalities is illustrated with findings from the clinical studies and/or meta-analysis. The author elaborates the strengths and weaknesses of available evidence and smoothly navigates through different treatment options, including combinations.
This E-learning module is an update of the previous ESMO module that incorporates the key findings from recent clinical studies and provides an overview of currently ongoing intense research in this field.
The author presents the novelties in the section of perioperative immunotherapy, in particular, data from a range of neoadjuvant monotherapy phase II studies in patients with resectable NSCLC with nivolumab, durvalumab and atezolizumab, as well as featuring the results from the neoadjuvant combination CheckMate 816 study of nivolumab plus ipilimumab or nivolumab plus chemotherapy versus chemotherapy alone. The author also highlights the findings from the IMPOWER 010 phase III study of atezolizumab versus best supportive care following adjuvant chemotherapy for resected NSCLC. Furthermore, the author provides an overview of ongoing phase III studies testing adjuvant immune checkpoint inhibitors.
In the section of postoperative mediastinal radiotherapy, this updated module features the key findings from the Lung ART IFCT05-03 phase III study that compared post-operative conformal radiotherapy to no post-operative radiotherapy in patients with completely resected NSCLC and mediastinal N2 involvement.
In the section dedicated to EGFR mutated NSCLC, the author highlights the outcomes from the phase III clinical studies (CTONG, IMPACT WJOG6410L) with adjuvant EGFR tyrosine kinase inhibitors (TKIs) versus chemotherapy in patients with completely resected tumours and common EGFR activating mutations, while a part, dedicated to adjuvant EGFR TKI after chemotherapy strategy, features the findings from ADAURA study with osimertinib in resected EGFR mutated NSCLC.
This updated module provides a concise educational material in the field of perioperative treatment of NSCLC, allowing clinicians to keep abreast with recent novelties.
The author has reported the following financial interests:
- Bristol Myers Squibb: Personal, Scientific committee and invited speaker, Institutional, local PI and steering committee member. Other, support for meeting attendance
- MSD: Personal, advisory board, scientific committee and invited speaker, Coordinating PI, Institutional
- Amgen, Takeda: Advisory Board, Personal
- Astra Zeneca: Invited Speaker, Personal. Other, support for meeting attendance
- Roche: Invited Speaker, Personal, Local PI, Institutional
- Sanofi: Other, support for meeting attendance.