Tackling the immunotherapy conundrum: advances and challenges for operable non-small-cell lung cancer treatment

Lung cancer is the most common cause of cancer-related deaths worldwide. Non-small-cell lung cancer (NSCLC) represents the majority of lung cancer cases, and its standard treatment is primarily surgery. Nonetheless, this type of cancer exhibits an important rate of tumor recurrence. Immune checkpoint inhibitors (ICIs) have demonstrated significant survival benefits in many cancers, especially in early-stage NSCLC. This review considers the latest CheckMate816, IMpower010 and KEYNOTE-091 trials that led to US FDA approvals. The new wave of resectable NSCLC trial results are also summarized. Finally, the latest challenges for these treatment modalities, such as the choice between neoadjuvant and adjuvant use, the accurate identification of biomarkers and the presence of driver mutations such as EGFR, are discussed. This article explains new results from cancer trials. In fact, the US FDA approved new treatments because of these findings. We sum up how cancer drugs help immune cells kill lung tumors. Moreover, the most common type of these tumors is non-small-cell lung cancer, a group that responds well to these drugs. The article provides a brief review of 2023 results to help both patients and doctors. Finally, some significant debates are presented. Among these questions are the following: Is treatment better before or after surgery? Will mutations reduce drug benefit? How can we tell whether the drug will work? Who can take these medicines? Will new tech help doctors? This article summarizes the latest ICI trials for operable NSCLC and the corresponding FDA approvals. Controversial issues such as EGFR-positive cases, neoadjuvant versus adjuvant, novel biomarkers and artificial intelligence are discussed.