ReviewAnnals of surgical oncology2025
Difficult Decisions in the Multidisciplinary Treatment of Resectable Non-small Cell Lung Cancer.
Review in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed.
- Survival of Squamous Cell Carcinoma Versus Adenocarcinoma in Resected Stage I-III Non-small Cell Lung Cancer.Annals of surgical oncology · 2026Article
- KRT16 and APOA1: key regulators of proliferation and lipid metabolism in non-small cell lung cancer.Open life sciences · 2026Article
- The Role of Immunotherapy in Resectable Non-Small Cell Lung Cancer.Oncology research · 2026Review
- The staging evolution dilemma: TNM-9 sharpens anatomical precision, but is biology still offstage?Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The management of resectable non-small cell lung cancer (NSCLC) has evolved dramatically over the past three decades. Once limited to surgery, treatment strategies now include chemotherapy, immunotherapy, radiation, and targeted therapies. Despite advances in clinical trials and updated guidelines, several gray areas persist in practice. This review highlights two commonly encountered dilemmas, framed by recent trial data. The first dilemma is centered on the question: for a patient with a 4.1 cm node-negative tumor, is the optimal approach neoadjuvant, adjuvant, or perioperative chemoimmunotherapy? CheckMate 816 demonstrated improved pathological complete response and event-free survival with neoadjuvant chemoimmunotherapy. Perioperative approaches, combining neoadjuvant and adjuvant immunotherapy, showed promising outcomes in KEYNOTE-671, AEGEAN, and CheckMate 77T, whereas IMpower010 and KEYNOTE-091 demonstrated benefit with adjuvant therapy. Moreover, for patients with EGFR or ALK mutations, targeted therapies have shifted the treatment paradigm, as shown in the ADAURA and ALINA trials. However, no head-to-head comparisons among these strategies exist, limiting decision-making. The second dilemma involves a hypothetical scenario of a patient a with biopsy-proven T1cN2 disease: should treatment involve neoadjuvant chemoimmunotherapy followed by surgery, or chemoradiation followed by consolidation immunotherapy (durvalumab) or targeted agents (such as osimertinib)? The PACIFIC and LAURA trials support the latter approach for unresectable disease, while CheckMate 816 supports surgery for resectable N2 cases. Yet defining resectability remains subjective, especially with multistation or bulky N2 disease. While the upcoming AJCC 9th edition proposes a subdivision of N2 into N2a (single-station) and N2b (multi-station), offering a potential step forward, this refinement has yet to translate into clear clinical guidance. These scenarios highlight the need for prospective, stage stratified trials, designed to address these pertinent questions so that improved guidelines may help clinical decision making in borderline cases.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.