Non-small cell lung cancer in China

Cancer Commun (Lond). 2022 Oct;42(10):937-970. doi: 10.1002/cac2.12359. Epub 2022 Sep 8.

Abstract

In China, lung cancer is a primary cancer type with high incidence and mortality. Risk factors for lung cancer include tobacco use, family history, radiation exposure, and the presence of chronic lung diseases. Most early-stage non-small cell lung cancer (NSCLC) patients miss the optimal timing for treatment due to the lack of clinical presentations. Population-based nationwide screening programs are of significant help in increasing the early detection and survival rates of NSCLC in China. The understanding of molecular carcinogenesis and the identification of oncogenic drivers dramatically facilitate the development of targeted therapy for NSCLC, thus prolonging survival in patients with positive drivers. In the exploration of immune escape mechanisms, programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitor monotherapy and PD-1/PD-L1 inhibitor plus chemotherapy have become a standard of care for advanced NSCLC in China. In the Chinese Society of Clinical Oncology's guidelines for NSCLC, maintenance immunotherapy is recommended for locally advanced NSCLC after chemoradiotherapy. Adjuvant immunotherapy and neoadjuvant chemoimmunotherapy will be approved for resectable NSCLC. In this review, we summarized recent advances in NSCLC in China in terms of epidemiology, biology, molecular pathology, pathogenesis, screening, diagnosis, targeted therapy, and immunotherapy.

Keywords: clinical guidelines; clinical trials; epidermal growth factor receptor (EGFR) mutation; immunotherapy; non-small cell lung cancer; programmed cell death protein 1 (PD-1); programmed death-ligand 1 (PD-L1); screening; targeted therapy.

Publication types

  • Review

MeSH terms

  • B7-H1 Antigen / metabolism
  • Carcinoma, Non-Small-Cell Lung* / epidemiology
  • Carcinoma, Non-Small-Cell Lung* / genetics
  • Carcinoma, Non-Small-Cell Lung* / therapy
  • Humans
  • Immune Checkpoint Inhibitors
  • Lung Neoplasms* / epidemiology
  • Lung Neoplasms* / genetics
  • Lung Neoplasms* / therapy
  • Programmed Cell Death 1 Receptor / metabolism

Substances

  • B7-H1 Antigen
  • Immune Checkpoint Inhibitors
  • Programmed Cell Death 1 Receptor