The cornerstone of treating early NSCLC (stage I, II, and sometimes stage IIIA) is surgery, at least if a patient is able to tolerate that. While many patients can be cured after surgery alone, patients remain at risk for both local recurrence near where the original cancer was, and also distant spread. The latter is caused by micrometastases, circulating tumor cells that cannot be detected on scans or blood tests at this time, that can grow to produce visible disease recurrence months or years after surgery.

A recent trial by Olaussen and colleagues was just published in the New England Journal of Medicine that suggested that in the future oncologists may become better at identifying the patients who are more or less likely to benefit from chemotherapy after surgery for early stage non-small cell lung cancer.