Surgery is the optimal treatment for early-stage non-small cell lung cancer (NSCLC). Although surgical resection achieves locoregional control, distal recurrences that results in poor survival rates have been a challenge. At the end of the last century, the discovery of oncogene-driven tumors completely changed the therapeutic landscape in lung cancers, harbouring specific gene mutations/translocations. Targeted therapies have markedly improved the management of patients with advanced NSCLC, but their efficacy in localized NSCLC is less well established.
Recent successes in immunotherapeutic strategies are been investigated to combat NSCLC that have less than ideal responses to standard of care treatment. While newer immunotherapeutic strategies are being investigated for advanced NSCLC, studies that have investigated the tumor immune microenvironment in early-stage NSCLC have shed light on potential neoadjuvant and adjuvant immunotherapeutic strategies by differentiating specific immunological milieus with prognostic indication, thereby providing a direction for therapies to shift the balance towards an antitumor immune response.
Target therapy and immunotherapy for NSCLC has emerged as a promising field for development. The knowledge obtained from clinical trials will eventually lead to novel neoadjuvant and adjuvant targets and/or immunotherapeutic strategies that can prolong survival in surgically treated NSCLC patients.