Vnitr Lek 2025, 71(4):224-227 | DOI: 10.36290/vnl.2025.041

Overview of lung cancer treatment according to ESMO recommendations

Martin Svatoň

Klinika pneumologie a ftizeologie, FN a LF UK Plzeň

Lung cancer continues to rank among the top malignant neoplasms in the Czech Republic in terms of incidence and mortality. The correct decision about treatment depends on high-quality staging, biopsy examination including predictive markers, the patient's overall condition and comorbidities, and last but not least, the patient's wishes. Given the evolving treatment options, decision-making is key in an experienced multidisciplinary team (MDT), where the treatment schemes listed in the guidelines are a valuable guide, but not always dogma. In small cell lung cancer (SCLC), surgical resection plus chemotherapy may be considered in early stages. In locally advanced SCLC, treatment consists of chemoradiotherapy plus subsequent immunotherapy. Advanced stages of SCLC are usually treated with chemoimmunotherapy. In non-small cell lung cancer (NSCLC), the earliest stage of the tumour is intended for resection. For higher operable stages of NSCLC (operability is assessed by MDT) without targetable mutations, neoadjuvant chemoimmunotherapy is usually chosen with subsequent resection and possible adjuvant immunotherapy. For locally advanced inoperable NSCLC, the method of choice is chemoradiotherapy, possibly supplemented (according to predictive markers) with other treatments. For metastatic disease, we usually choose from targeted therapy, immunotherapy or chemoimmunotherapy. The treatment team should not neglect either local treatment options or supportive treatment. Finally, the treatment team must have sufficient experience with treatment-induced adverse effects.

Keywords: NSCLC, SCLC, targeted therapy, immunotherapy.

Accepted: June 3, 2025; Published: June 19, 2025  Show citation