Abstract
Recent major advances in metastatic non-small cell lung cancer have occurred with the identification of molecular biomarker targets and administration of novel agents with resulting improvement in clinical outcomes. In the early-stage setting, personalized therapy with novel agents and molecular profiling are being incorporated into neoadjuvant "window-of-opportunity" trials. These important studies enable biomarker research and an expedited analysis of the efficacy of the targeted agent. However, there are significant limitations to window-of-opportunity trials. The aim of this article is to review the current window-of-opportunity trials of neoadjuvant targeted agents for thoracic malignancies, discuss the benefits and limitations of these trials, and propose more optimal alternative trial end points. Neoadjuvant trials of resectable non-small cell lung cancer and mesothelioma that are ongoing or under development and relevant to thoracic surgeons are also discussed. The success of these trials will depend on a collaborative multidisciplinary effort, especially from the field of thoracic surgery.
Original language | English (US) |
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Pages (from-to) | 323-330 |
Number of pages | 8 |
Journal | Seminars in thoracic and cardiovascular surgery |
Volume | 26 |
Issue number | 4 |
DOIs | |
State | Published - Jan 1 2014 |
Keywords
- NSCLC
- Neoadjuvant
- Targeted agents
- Thoracic malignancies
- Window-of-opportunity trials
ASJC Scopus subject areas
- Surgery
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine