Pathological complete response as a surrogate endpoint after neoadjuvant therapy for lung cancer

6 years have passed since Matthew Hellman and colleagues 1 Hellmann MD Chaft JE William Jr, WN et al. Pathological response after neoadjuvant chemotherapy in resectable non-small-cell lung cancers: proposal for the use of major pathological response as a surrogate endpoint. Lancet Oncol. 2014; 15: e42-e50 Summary Full Text Full Text PDF PubMed Scopus (187) Google Scholar proposed major pathological response as a surrogate endpoint of survival for patients undergoing neoadjuvant therapy for operable lung cancer. Since then, an explosion of new trials have emerged, investigating a wide range of novel therapeutics in the preoperative window. Conceptually, neoadjuvant systemic treatment offers several advantages, including targeting occult micrometastatic disease before surgery, downstaging unresectable cancers to render them resectable, and offering an opportunity for patients to be pre-habilitated for their surgical intervention. From a research standpoint, neoadjuvant therapy creates a unique setting for discovery around treatment response and failure. The suboptimal survival outcomes for patients with operable lung cancer continue for our patients and represent a clear unmet need. 2 Chaft JE Rimner A Weder W Azzoli CG Kris MG Cascone T Evolution of systemic therapy for stages I-III non-metastatic non-small-cell lung cancer. Nat Rev Clin Oncol. 2021; (published online April 28.)https://doi.org/10.1038/S41571-021-00501-4 Crossref Scopus (10) Google Scholar