2024 Asia Conference on Lung Cancer (ACLC) - Poster & ePosters-PP02.43

PP02.43 - Stephanie Saw

Pdf Summary

The Asian Thoracic Oncology Research Group (ATORG) released a consensus statement regarding the peri-operative management of non-small cell lung cancer (NSCLC), informed by a meeting held in Singapore in April 2024. The statement addresses the integration of immune checkpoint inhibitors and targeted therapies in treating earlier-stage NSCLC. Despite advancements, challenges remain, particularly in applying clinical trial data to everyday practice.<br /><br />A panel of 19 experts, including medical oncologists and thoracic surgeons from various Asia-Pacific countries, discussed key aspects: molecular testing, local therapies, peri-operative immunotherapy plus chemotherapy, adjuvant targeted therapy, and future directions. Each topic was explored in detail, and recommendations were made based on consensus among the experts.<br /><br />Highlights from the consensus include:<br /><br />- Molecular testing: PD-L1 testing is recommended for all patients with stage IB-III NSCLC. EGFR and ALK testing should be done for non-squamous histology. PET CT scans are advised pre-operatively for pathologically-confirmed clinical stage IB-III NSCLC.<br /><br />- Peri-operative therapy: Neoadjuvant chemo-immunotherapy is suggested for resectable stage IIB-IIIA NSCLC, assuming no contraindications, with a preferred interval of 4-6 weeks until surgery.<br /><br />- Adjuvant targeted therapy: Upfront surgery followed by adjuvant osimertinib is favored for stage IB-IIIA NSCLC with EGFR mutations. ALK-rearranged NSCLC should be treated with adjuvant alectinib following upfront surgery.<br /><br />The consensus seeks to provide a framework for managing NSCLC patients, specifically tailored to the Asia-Pacific context, while acknowledging areas needing further research and consensus, such as the re-evaluation of PD-L1 testing on surgical specimens and standards for neoadjuvant therapy.

Keywords

Asian Thoracic Oncology Research Group

non-small cell lung cancer

NSCLC

immune checkpoint inhibitors

targeted therapies

peri-operative management

molecular testing

adjuvant therapy

Asia-Pacific

consensus statement