Induction immunotherapy plus chemotherapy for Pancoast lung cancer tumors: are we ready to shift our standards?

Pancoast tumors are a distinct and rare subset of non-small-cell lung cancers (NSCLCs). Although a trimodality approach combining induction chemoradiotherapy followed by surgery has been the standard of care over the past two decades, only a limited number of patients are eligible for this intensive treatment in routine clinical practice. Moreover, surgical procedures for Pancoast tumors often require highly specialized thoracic surgery centers. Recent studies evaluating induction chemoimmunotherapy in resectable NSCLC have demonstrated clinically meaningful outcomes, establishing this strategy as a new standard of care. Given these promising results, the application of this approach in patients with resectable Pancoast tumors warrants further investigation. In this communication, we report surgical and pathological findings following induction chemoimmunotherapy in this specific setting. Additionally, we discuss the potential advantages, limitations, and future challenges of integrating this approach into the standard clinical management of Pancoast tumors.