Feasibility of Surgery for Advanced NSCLC Treated with Tyrosine Kinase Inhibitors as Neoadjuvant Therapy

The role of surgical resection after tyrosine-kinase inhibitor (TKI) treatment in locally advanced NSCLC remains controversial. There have benn scanty case reports of successful treatment outcome resulting from complete resection post-TKI response. However, there is no consensus on indication or timing of surgical resection in locally advanced NSCLC treated with TKIs. We present the cases of 10 patients with NSCLC stage IIIa~VI who received TKIs as first-line treatment. Surgical resection was performed in various situations, including those in which complete resection could be achieved and those in which the patient could not withstand the adverse effects of TKI. Surgical outcomes and survival patterns were acceptable. TKIs can be used as neoadjuvant therapy, but further research should indicate the timing of surgery and the criteria of patient selection. We believe future clinical trial should be conducted to evaluate this treatment modality.