Nonmetastatic Non-Small Cell Lung Cancer — An Interview with Dr Jamie E Chaft

Nonmetastatic non-small cell lung cancer management has shifted toward neoadjuvant chemoimmunotherapy, significantly improving pathologic complete response rates and overall survival. Clinical practice now emphasizes multidisciplinary staging and the integration of perioperative checkpoint inhibitors, particularly for patients with PD-L1 expression. While CheckMate 816 established the neoadjuvant paradigm, ongoing research explores the role of targeted therapies like osimertinib for EGFR-mutant disease, as demonstrated in the NeoADAURA study. Despite these advances, challenges remain in determining the necessity of adjuvant phases and managing immune-related toxicities, such as hypothyroidism. Current diagnostic protocols rely on invasive mediastinal staging and molecular profiling, though the clinical utility of ctDNA for treatment de-escalation remains limited by current assay sensitivity. Future strategies aim to refine patient selection and optimize treatment duration to improve long-term outcomes in both resectable and locally advanced unresectable settings.