Adjuvant chemotherapy in non-small cell lung cancer – how it is used in the practice

Adjuvant chemotherapy is a standard treatment method for non-small cell lung cancer (NSCLC) in stages IB (in tumours ≥ 4 cm indiameter), II, and IIIA. The recommendation is based on the results of a series of phase 3 trials and large meta-analyses that haveconfirmed the effect of adjuvant chemotherapy on the reduction in the relative risk of death and absolute improvement in fiveyearsurvival rates. There have been several population-based as well as regional studies evaluating the results of administrationof adjuvant chemotherapy outside clinical trials. They mainly differ in the inclusion of patients whose selection is not influencedby exclusion criteria of randomized trials and whose health status corresponds to the general population. In the clinical practice,it is possible to discuss the benefit of adjuvant chemotherapy on the one hand and the rates of adverse effects on the otherhand. Current efforts are aimed at improving efficacy and refining patient selection. Prognostic and predictive biomarkers aresought that would enable personalization of adjuvant chemotherapy. There have been initial studies showing the possibilities ofdelivering biologically targeted therapy or immunotherapy in patients with NSCLC after radical surgery.

Keywords: adjuvant chemotherapy, non-small cell lung cancer, personalization, real practice