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Fig. 1 | Biomarker Research

Fig. 1

From: Emerging precision neoadjuvant systemic therapy for patients with resectable non-small cell lung cancer: current status and perspectives

Fig. 1

The chronological milestones for the management of NSCLC. Major advances in systemic therapy with chemotherapy, targeted therapy and immunotherapy for NSCLC are illustrated. Beginning in 1990, chemotherapy was shown to be effective for prolonging survival in patients with NSCLC and platinum-based therapy became the cornerstone of treatment. Neoadjuvant or adjuvant chemotherapy modestly increased the overall survival by ~ 5% in patients with stage II-IIIA operable NSCLC. In 2004, targeted therapy erlotinib was approved for EGFR-sensitive NSCLC. During this time, researchers began utilizing modern gene sequencing programs to identify genetic markers for targeted therapeutics. The ALK gene rearrangement was identified and crizotinib was approved for ALK-positive tumors in 2011. In 2015, ICIs were found to improve survival and three immunotherapy agents were approved, including nivolumab, atezolizumab, and pembrolizumab. In 2018, a third-generation EGFR inhibitor osimertinib was approved as first line treatment for patients with metastatic NSCLC. By the end of 2020, adjuvant targeted therapy with osimertinib was approved for EGFR-sensitive NSCLC. In 2021, adjuvant immunotherapy with atezolizumab was approved for PD-L1 positive NSCLC. Neoadjuvant nivolumab and platinum-based chemotherapy becomes a standard of care for patients with stage IB-IIIA NSCLC without known EGFR or ALK genomic alterations in March 2022

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