随着下一代测序技术的广泛应用，基于分子状态的个体化治疗正用于可切除的早期非小细胞肺癌（NSCLC）患者。本叙述性综述的目的是关注早期疾病辅助治疗和新辅助/辅助治疗中靶向治疗的最新进展。我们在过去的10年内专注于MEDLINE/PubMed数据库进行了系统检索。我们的搜索查询了“早期 NSCLC (AND) 靶向酪氨酸激酶抑制剂 (TKI; OR) 表皮生长因子受体 (EGFR; OR) 间变型淋巴瘤激酶 (ALK)”并仅限于前瞻性和正在进行的研究。大多数研究在早期可切除的 NSCLC 中研究靶向治疗的效益主要集中在辅助治疗中的 EGFR-TKI。目前，只有一项研究，即 ADURA 试验，证明了辅助治疗中使用 EGFR-TKI 对总生存率有益。未来的工作将建立在 ADURA 试验的成功基础上，重点是确定靶向治疗的最佳持续时间，并使用循环肿瘤DNA等生物标志物对患者进行风险分层和指导维持性靶向治疗持续时间。我们急切期待几个进行中的研究结果，以了解在新辅助/辅助治疗中以及对于ALK、ROS原癌基因1、转染重排过程中重组和转录、间质-上皮转化因子和B-Raf原癌基因V600E等更罕见的突变时的靶向治疗的应用。早期带有可操作突变的 NSCLC 的治疗格局可能在未来十年内发生显著变化。

With increased adoption of next-generation sequencing, tailored therapy on the basis of molecular status is being delivered for patients with early-stage resectable non-small-cell lung cancer (NSCLC). The purpose of this narrative review was to focus on recent developments of targeted therapies in the adjuvant and neoadjuvant/adjuvant setting for early-stage disease.A systematic search of the MEDLINE/PubMed database was performed, focusing on studies published within the past 10 years. Our search queried "early-stage NSCLC (AND) tyrosine kinase inhibitor (TKI; OR) epidermal growth factor receptor (EGFR; OR) anaplastic lymphoma kinase (ALK)" and was limited only to prospective and ongoing studies.Most studies examining the benefit of targeted therapies in early-stage resectable NSCLC have been for EGFR-TKIs in the adjuvant setting. Currently, only one study, the ADAURA trial of adjuvant osimertinib, has demonstrated an overall survival benefit with the use of an EGFR-TKI in the adjuvant setting. Future work to build on the success of the ADAURA trial is focused on determining the optimal duration of targeted therapies and using biomarkers, such as circulating tumor DNA, to risk-stratify patients and guide maintenance targeted therapy duration.The results of several ongoing studies are eagerly awaited regarding the use of targeted therapies in the neoadjuvant/adjuvant setting and for more uncommon or rare mutations such as ALK, ROS proto-oncogene 1, rearranged during transfection, mesenchymal-epithelial transition factor, and B-Raf proto-oncogene V600E. The treatment landscape for early-stage NSCLC harboring actionable mutations is likely to shift dramatically in the upcoming decade.