Intended for healthcare professionals

Clinical Review State of the Art Review

Advances in systemic therapy for non-small cell lung cancer

BMJ 2021; 375 doi: (Published 09 November 2021) Cite this as: BMJ 2021;375:n2363
  1. Meagan Miller, hematology/oncology fellow,
  2. Nasser Hanna, professor of medicine, Tom and Julie Wood Family Foundation professor of lung cancer clinical research
  1. Indiana University School of Medicine, Indianapolis, IN 46208, USA
  1. Correspondence to: M Miller meaemill{at}


Lung cancer remains a leading cause of cancer related mortality worldwide. Despite numerous advances in treatments over the past decade, non-small cell lung cancer (NSCLC) remains an incurable disease for most patients. The optimal treatment for all patients with locally advanced, but surgically resectable, NSCLC contains at least chemoradiation. Trimodality treatment with surgical resection has been a subject of debate for decades. For patients with unresectable or inoperable locally advanced disease, the incorporation of immunotherapy consolidation after chemoradiation has defined a new standard of care. For decades, the standard of care treatment for advanced stage NSCLC included only cytotoxic chemotherapy. However, with the introduction of targeted therapies and immunotherapy, the landscape of treatment has rapidly evolved. This review discusses the integration of these innovative therapies in the management of patients with newly diagnosed NSCLC.


  • Series explanation: State of the Art Reviews are commissioned on the basis of their relevance to academics and specialists in the US and internationally. For this reason they are written predominantly by US authors

  • Contributors: NH and MM contributed equally to the manuscript idea, literature search, and review article writing. NH is the guarantor.

  • Competing interest: We have read and understood the BMJ policy on declaration of interests and declare the following interests: NH receives research support from Genentech, Merck, AstraZeneca, and Bristol Myers Squibb for investigator initiated research; he also receives royalties from UptoDate for work as an editor for the adjuvant section in lung cancer.

  • Provenance and peer review: Commissioned; externally peer reviewed.

  • Patient involvement: No patients were involved in the writing of this review.

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