Excellence in oncology care (EIOC) consensus guidelines on integrating immunotherapy (IO) in resectable non-small cell lung cancer (NSCLC) for the Middle East and Indian subcontinent

ABSTRACT The Excellence in Oncology Care (EIOC) 2023 Congress, held in Dubai, took place both in person and online. This annual event brought together oncologists from across the Middle East and the Indian subcontinent. A panel of 17 regional experts worked together to develop the first region-specific consensus guidelines. A survey was conducted among the panelists, followed by a preparatory meeting to discuss the results and formulate the guidelines. These guidelines were then presented and discussed at the congress. The panel addressed non-small cell lung cancer (NSCLC), focusing specifically on integrating immunotherapy in resectable NSCLC. The management of NSCLC is advancing, particularly in the early stages. For stages II to IIIA, adjuvant platinum-based chemotherapy is recommended, but new therapies are needed due to limited efficacy. Immunotherapy, including atezolizumab and pembrolizumab, is now standard for resected stage I-III NSCLC, though challenges in clinical uptake and biomarker testing persist. Comprehensive staging evaluation, including positron emission tomography-computed tomography, mediastinal assessment, and central nervous system screening, is advised. EGFR and ALK biomarker testing, along with multidisciplinary team discussions, is crucial. Adjuvant immunotherapy decisions should be guided by PD-L1 status, with atezolizumab or pembrolizumab recommended for 12 months. Neoadjuvant ICI therapy with chemotherapy is suggested for stages IB to IIIA/B NSCLC. The EIOC guidelines offer detailed insights into NSCLC management.