Neoadjuvant versus adjuvant chemotherapy for resectable non-small cell lung cancer debate revisited

The use of adjuvant platinum-based chemotherapy for surgically resectable non-small cell lung cancer (NSCLC) has been well established by several randomized trials and meta-analysis which demonstrated clear survival benefit over no chemotherapy (1-5). However, evidence is less robust regarding the benefit of neoadjuvant chemotherapy (NC). Goals of administering chemotherapy in the preoperative setting (neoadjuvant) include increasing operability by possibly reducing tumor size, improving the likelihood of receiving the maximal planned dose, and reducing the likelihood of micrometastasis.