Lung Cancer Treatment Evolves: Pre- and Post-Surgery Immunotherapy Gains Traction
Lung cancer, even with tumors as small as 3-4cm, often presents with distant metastases, with over 80% of recurrences stemming from such spread. This reality underscores teh growing importance of systemic anticancer treatments administered both before and after surgical intervention.
Historically, chemotherapy was primarily reserved for patients deemed inoperable. However, its application has significantly broadened, now extending to neoadjuvant (pre-surgery) and adjuvant (post-surgery) settings, even for earlier stages of the disease. Previously, patients with Stage IIIA lung cancer might have undergone surgery followed by chemotherapy and radiation. Current treatment strategies are increasingly incorporating immunotherapy into this perioperative timeline.
Evidence from Phase III clinical trials demonstrates a substantial benefit from combining neoadjuvant and adjuvant chemotherapy with immunotherapy (specifically mentioning Keytruda). These trials showed an enhancement in median survival from 18.4 months to 57.1 months compared to chemotherapy alone. Furthermore, the risk of recurrence, progression, or death was reduced by 43%, and the rate of complete pathological response-where no viable cancer cells are found after treatment-more than quadrupled.
In south Korea, the use of immunotherapy before and after surgery for lung cancer received approval in 2022. Yonsei Cancer hospital has been actively integrating these perioperative immunotherapy regimens since 2023. This year, approximately 10% of all lung cancer surgeries at the hospital now include pre- and post-operative immunotherapy alongside chemotherapy.
Professor Lee Chang-young highlighted this shift, emphasizing a move towards personalized, precision medicine in lung cancer care, away from a sole focus on the speed of intervention.He also noted that many patients diagnosed with lung cancer are surprised to learn they have the disease, especially if they are non-smokers. Early-stage lung cancer, characterized by small tumor sizes, generally has a higher success rate with treatment.
By Jung Jin-soo, Staff Reporter jen@segye.com
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