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Opinion|Videos|April 9, 2026

Surgical Considerations After Neoadjuvant Therapy in EGFR-Mutated NSCLC

Author(s)Alexander Spira, MD, PhD, FACP, FASCO, Ticiana Leal, MD, Natalie Vokes, MD

Fact checked by: Justin Mancini

In this segment, Dr. Alexander Spira and Dr. Natalie Vokes explore the impact of neoadjuvant targeted therapy on surgical planning and outcomes in early-stage EGFR-mutated non–small cell lung cancer (NSCLC).

Episodes in this series

EP. 1 Evolving Adjuvant Therapy in Early-Stage EGFR-Mutated NSCLC: Insights From ADAURA

EP. 1 Evolving Adjuvant Therapy in Early-Stage EGFR-Mutated NSCLC: Insights From ADAURA

EP. 2 Neoadjuvant Strategies and Early Biomarker Testing in EGFR-Mutated NSCLC

EP. 2 Neoadjuvant Strategies and Early Biomarker Testing in EGFR-Mutated NSCLC

EP. 3 EGFR Biology and Treatment Selection Beyond PD-L1 in EGFR-Mutated NSCLC

EP. 3 EGFR Biology and Treatment Selection Beyond PD-L1 in EGFR-Mutated NSCLC

EP. 4 Osimertinib Across Stages: Shaping Early-Stage EGFR-Mutated NSCLC Care

EP. 4 Osimertinib Across Stages: Shaping Early-Stage EGFR-Mutated NSCLC Care

EP. 5 Interpreting EGFR-TKI Evidence for Early-Stage EGFR-Mutated NSCLC

EP. 5 Interpreting EGFR-TKI Evidence for Early-Stage EGFR-Mutated NSCLC

EP. 6 Real-World Outcomes With EGFR-TKIs in Early-Stage EGFR-Mutated NSCLC

EP. 6 Real-World Outcomes With EGFR-TKIs in Early-Stage EGFR-Mutated NSCLC

EP. 7 Biomarker Testing at Diagnosis in Early-Stage EGFR-Mutated NSCLC

EP. 7 Biomarker Testing at Diagnosis in Early-Stage EGFR-Mutated NSCLC

EP. 8 Multidisciplinary Coordination in EGFR-Mutated NSCLC Treatment Planning

EP. 8 Multidisciplinary Coordination in EGFR-Mutated NSCLC Treatment Planning

EP. 9 Neoadjuvant Decision-Making in EGFR-Mutated NSCLC

EP. 9 Neoadjuvant Decision-Making in EGFR-Mutated NSCLC

EP. 10 Setting Expectations for Long-Term Therapy in EGFR-Mutated NSCLC

EP. 10 Setting Expectations for Long-Term Therapy in EGFR-Mutated NSCLC

EP. 11 Managing EGFR-TKI Toxicities in Early-Stage EGFR-Mutated NSCLC

EP. 11 Managing EGFR-TKI Toxicities in Early-Stage EGFR-Mutated NSCLC

EP. 12 Driving Guideline-Aligned Care in EGFR-Mutated NSCLC

EP. 12 Driving Guideline-Aligned Care in EGFR-Mutated NSCLC

EP. 13 Shared Decision-Making in Early-Stage EGFR-Mutated NSCLC

EP. 13 Shared Decision-Making in Early-Stage EGFR-Mutated NSCLC

EP. 14 Patient Selection for Adjuvant Therapy in EGFR-Mutated NSCLC

EP. 14 Patient Selection for Adjuvant Therapy in EGFR-Mutated NSCLC

EP. 15 Motivating Treatment Persistence in EGFR-Mutated NSCLC

EP. 15 Motivating Treatment Persistence in EGFR-Mutated NSCLC

EP. 16 Long-Term Toxicity Management in EGFR-Mutated NSCLC

EP. 16 Long-Term Toxicity Management in EGFR-Mutated NSCLC

EP. 17 Counseling Persistence in EGFR-Mutated NSCLC Therapy

EP. 17 Counseling Persistence in EGFR-Mutated NSCLC Therapy

EP. 18 Biopsy-Driven Neoadjuvant Planning in EGFR-Mutated NSCLC

EP. 18 Biopsy-Driven Neoadjuvant Planning in EGFR-Mutated NSCLC

EP. 19 Defining Meaningful Outcomes in Neoadjuvant EGFR-Mutated NSCLC

EP. 19 Defining Meaningful Outcomes in Neoadjuvant EGFR-Mutated NSCLC

EP. 20 Surgical Considerations After Neoadjuvant Therapy in EGFR-Mutated NSCLC

EP. 20 Surgical Considerations After Neoadjuvant Therapy in EGFR-Mutated NSCLC

EP. 21 Transitioning to Adjuvant Therapy in EGFR-Mutated NSCLC

EP. 21 Transitioning to Adjuvant Therapy in EGFR-Mutated NSCLC

EP. 22 The Role of Early Biomarker Testing in EGFR-Mutated NSCLC

EP. 22 The Role of Early Biomarker Testing in EGFR-Mutated NSCLC

In this segment, Dr. Alexander Spira and Dr. Natalie Vokes explore the impact of neoadjuvant targeted therapy on surgical planning and outcomes in early-stage EGFR-mutated non–small cell lung cancer (NSCLC). Dr. Vokes provides a surgeon’s perspective on how preoperative therapy may influence tumor characteristics, operative complexity, and resectability. The discussion highlights considerations such as changes in tumor size, tissue planes, and potential effects on surgical timing. Dr. Vokes also addresses how neoadjuvant therapy may impact post-operative recovery and the importance of maintaining close coordination between surgical and medical oncology teams. The conversation emphasizes the need to balance potential benefits of tumor response with preserving optimal surgical conditions. This segment underscores the critical role of multidisciplinary collaboration in ensuring that neoadjuvant strategies are integrated safely and effectively into the treatment of EGFR-mutated NSCLC.

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