LUNG AND MEDIASTINUM: Edited by Robert Pirker and Caicun ZhouOpportunities and challenges of neoadjuvant targeted therapy in nonsmall cell lung cancerZou, Ji’ana,e; Zeng, Yuea; Wu, Fanga,b,c,d Author Information aDepartment of Oncology, The Second Xiangya Hospital, Central South University bHunan Cancer Mega-Data Intelligent Application and Engineering Research Centre cHunan Key Laboratory of Tumor Models and Individualized Medicine dHunan Key Laboratory of Early Diagnosis and Precision Therapy in Lung Cancer, The Second Xiangya Hospital eXiangya School of Medicine, Central South University, Changsha, Hunan, China Correspondence to Fang Wu, Changsha 410011, Hunan, China. Tel: +86 13574858332; fax: +86 073185294079; e-mail: [email protected] Current Opinion in Oncology 35(1):p 22-30, January 2023. | DOI: 10.1097/CCO.0000000000000914 Buy Metrics Abstract Purpose of review The aim of this study is to summarize the completed and ongoing clinical trials of neoadjuvant targeted therapy, discuss tolerability and efficacy, and explain the role of neoadjuvant targeted therapy in patients with resectable nonsmall cell lung cancer (NSCLC). At the same time, the existing challenges are presented, including assessment methods, biomarkers, surrogate endpoints and so on. We also put forward our views on possible ways to make improvements and establish neoadjuvant therapy a standard treatment in resectable NSCLC. Recent findings The mortality of lung cancer has decreased in the last 10 years, which can partly be attributed to advancement of targeted therapy. Targeted therapy has become the first-line treatment for patients with advanced mutation gene positive NSCLC, achieving the effect of prolonging overall survival (OS). Compared with chemotherapy, targeted therapy is associated with good tolerability and high response rate. Neoadjuvant targeted therapy has emerged in recent years and attracted attention of researchers. Early findings proved that neoadjuvant targeted therapy alone can improve patients’ disease-free survival (DFS) and the efficacy of combining with other forms of neoadjuvant therapy is also being explored by researchers. Summary Neoadjuvant targeted therapy is playing an important role in NSCLC and worth more in-depth research. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.