Neo-Adjuvant Therapies in Lung Cancer – Past Present and Future Directions

Lung cancer is the leading cause of neoplasm mortality worldwide, with most cases being non-small cell lung cancer (NSCLC). Over the last 20 years, the treatment of lung cancer has changed significantly and includes the neo-adjuvant and adjuvant setting. Initially, adjuvant chemotherapy presented curative benefit in stages beyond Ib. Recently, targeted therapy and immunotherapy has been implemented in that setting. The neo-adjuvant setting has been investigated mainly with concomitant radiation, while systemic therapy has not shown a breakthrough yet. This review summarizes adjuvant therapy, present neoadjuvant immunotherapy, and explores future neoadjuvant targeted therapy treatments of NSCLC. In addition, we will mention the use of induction-targeted therapy prior to radiotherapy for unresectable NSCLC. This includes both completed and ongoing clinical trials.