Surgery in the Era of Neoadjuvant Immune Checkpoint Inhibitors Therapy for Thoracic Oncology
A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".
Deadline for manuscript submissions: 25 November 2025 | Viewed by 22
Special Issue Editor
Interests: horacic surgery; RATS; thoracic oncology; airway surgery
Special Issues, Collections and Topics in MDPI journals
Special Issue Information
Dear Colleagues,
NSCLC accounts for 80–85% of all lung cancers, and approximately 20% are diagnosed in stage IIIA-IIIB. The optimal treatment for patients with stage IIIA-IIIB remains unclear, being a heterogeneous condition involving various combinations of tumor size and local nodal involvement. Stage IIIB is generally considered unsuitable for resection, with occasional exceptions determined by multidisciplinary teams.
Recent trials have demonstrated that the addition of immune checkpoint inhibitors (ICIs) to chemotherapy (CHT) in the neoadjuvant (NA) setting improves response and survival outcomes in intention-to-treat (ITT) populations. As the application of NA ICI-CHT has been accepted, the boundaries for resectability are being re-examined.
The question of the real resectability after a radiographic response is still unanswered. For patients who are borderline resectable due to the anatomical location of a tumor, it is unclear whether radiographic downstaging leads to surgical downstaging; in fact, challenging dissection due to fibrosis or suspicion of residual N2 after NA therapy is considered a limitation to upfront surgery.
However, with the increasing results of ICI-CHT, many tumors may be amenable to R0, and the interest in downstaging borderline unresectable disease has increased. More reports on high-volume centers’ experiences are needed to detect, validate, and sharare programs of treatment.
Prof. Dr. Mohsen Ibrahim
Guest Editor
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Keywords
- neoadjuvant therapy
- immune checkpoint inhibitors
- unresectable disease
- lung cancer
- locally advanced lung cancer
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