This Series paper reviews the evolving treatment landscape for early-stage resectable non-small-cell lung cancer (NSCLC), covering neoadjuvant and perioperative immunotherapy, targeted therapies, and radiotherapy, with a focus on evidence from randomised trials.
Perioperative immunotherapy and targeted therapies have established a new standard of care for resectable early-stage NSCLC, moving beyond the modest survival gains of surgery plus platinum-based chemotherapy alone; however, key uncertainties remain around optimal sequencing, treatment duration, patient selection, and escalation or de-intensification strategies.
This is a narrative review/Series paper, not a primary trial — no original patient-level data are presented. Conclusions depend on the quality and completeness of the cited randomised trials. Specific subgroup analyses and long-term survival data for newer regimens may still be maturing.
Clinicians treating resectable early-stage NSCLC should consider perioperative immunotherapy or targeted therapy as the new standard, while remaining attentive to ongoing uncertainties around sequencing, biomarker-driven patient selection, and whether to escalate or de-intensify treatment in specific populations.
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