Management of early stage non-small cell lung cancer

Management of early stage non-small cell lung cancer

It is a great honor to serve as Guest Editor for this special issue of Translational Lung Cancer Research devoted to early stage lung cancer. While lung cancer remains a leading cause of cancer death for both men and women globally, rapid advances in our understanding of the disease have led to significant improvements in recent years. In this issue we have brought together a truly multidisciplinary group of experts to discuss the challenges and advances that have been made in diagnosis and treatment of patients with potentially curable disease.

The first few chapters bring us the latest in interventional pulmonology approaches to aid in diagnosis and management, and discussions of alternatives to surgery for patients with early stage lung cancer, including radiation oncology techniques such as stereotactic body radiation therapy (SBRT) and interventional radiology strategies. In the next couple of chapters we have surgical viewpoints on the management of ground glass nodules and an in-depth discussion on optimal pathologic staging of resectable NSCLC.

From there we move to prognostic and predictive biomarkers to guide management of NSCLC. These include articles on tumor-based approaches such as gene signatures and serum/plasma markers like circulating tumor cells (CTCs). Advances in these areas help to guide our selection of therapy for patients both before and after surgical resections. The final articles focus predominantly on systemic therapy aimed at improving cure rates in patients with resectable NSCLC including detailed reviews on chemotherapy in this setting from a global perspective.

Our knowledge of molecular driver mutations with specific targeted therapy including EGFR and EML4-ALK has revolutionized the therapy of advanced stage adenocarcinoma of the lung. Those developments have not yet translated into a paradigm shift for treatment of earlier stage, curable disease, but extensive work is being done in this arena as discussed by Drs. Neal and Sequist in their article and accompanying video clip. Advances in immunotherapy of both squamous and non-squamous NSCLC are likely to drastically change our treatments of this disease in both the advanced and earlier stage setting. The final article comes back to the field of radiation therapy and its potential role after surgical resection.

This special issue includes authors from North America, Europe and Asia covering five different treatment modalities in addition to the basic science underlying therapeutic decisions. My hope is that readers will come away with a more thorough understanding of the state of the art and future directions in the care of patients with early stage NSCLC. I would like to express my gratitude to the world-renowned experts who have contributed and to the Editor-in-Chief for giving us all such a valuable opportunity to share this knowledge with the readers of Translational Lung Cancer Research.

Heather Wakelee, MD, Associate Professor of Medicine, Oncology
Stanford University, Stanford Cancer Institute, Stanford, CA 94305, USA

doi: 10.3978/j.issn.2218-6751.2013.10.08
Disclosure: The author declares no conflict of interest.

Cite this article as: Wakelee H. Management of early stage non-small cell lung cancer. Transl Lung Cancer Res 2013;2(5):315. doi: 10.3978/j.issn.2218-6751.2013.10.08