Dr. Vallieres Discusses Future Applications for Surgery in Lung Cancer

Eric Vallieres, MD, medical director, Division of Thoracic Surgery, Swedish Cancer Institute, discusses the potential for incorporating immunotherapy into surgical treatment for patients with lung cancer.

For patients with oncogene-driven non—small cell lung cancer (NSCLC), the advent of targeted therapies before and after surgery has not had much of an impact on the role of early-stage surgery, Vallieres says. There’s a lot of excitement about factoring immunotherapy into surgical therapy, but in what setting and for which patient population remains unclear. Another big unanswered question is whether immunotherapy will provide the same benefit in the neoadjuvant setting, when patients still have their lymph nodes and lymphatics in place.

Vallieres also notes how the PACIFIC trial has transformed the way researchers view lung cancer. In that study, the checkpoint inhibitor durvalumab (Imfinzi) demonstrated survival benefit in patients with locally advanced, unresectable stage III NSCLC who had not progressed following chemoradiotherapy. He says that researchers are wondering if a similar approach can be beneficial for patients with resectable disease, and if immunotherapy can be added to the backend of surgery to prolong survival.

This research is ongoing, but Vallieries says the preliminary data have been encouraging.