{
  "abstract": "Lung cancer is the leading cause of cancer-related mortality worldwide. Even after perioperative chemotherapy combined with immunotherapy, pathological complete response (pCR) rates remain below 30%, and further improvement in long-term outcomes has stalled. Antibody-drug conjugates (ADCs), leveraging targeted cytotoxicity and the bystander effect, can achieve tumor downstaging, micrometastasis clearance, and organ preservation in the perioperative setting, offering a new option beyond conventional chemoimmunotherapy. In this review, we aimed to summarize contemporary clinical evidence for perioperative ADCs in resectable non-small cell lung cancer (NSCLC) and to provide practical guidance on patient selection, toxicity management, and future research. We searched PubMed, Embase, Web of Science, and ClinicalTrials.gov, together with the abstract books of major oncology congresses [American Society of Clinical Oncology (ASCO), World Conference on Lung Cancer (WCLC), European Society for Medical Oncology (ESMO)], from January 1, 2018 to September 14, 2026 for English-language publications on ADCs in the perioperative treatment of resectable NSCLC. We included clinical trials, case reports, conference abstracts, guidelines, and authoritative reviews. Two authors independently screened and selected the literature; disagreements were resolved by consensus. Landmark studies published before 2018 were captured by reference-list screening. We cover TROP2-targeted agents (datopotamab deruxtecan, sacituzumab govitecan), HER2-directed trastuzumab deruxtecan, and bispecific EGFR-HER3 ADCs across neoadjuvant, adjuvant, and perioperative strategies, with attention to practice-changing platform trials such as NeoCOAST-2. Studies are grouped by therapeutic partner, namely ADCs combined with immune checkpoint inhibitors, ADCs combined with targeted agents, and ADCs administered as single agents in molecularly selected populations. We further examine how ADCs may substitute for, or complement, platinum-based chemotherapy, and how they interface with immune checkpoint inhibitors across the perioperative continuum. We discuss biomarker-guided patient selection, including TROP2 and HER2 expression and circulating tumor DNA (ctDNA)-based minimal residual disease (MRD); practical perioperative toxicity management (interstitial lung disease, oral mucositis, ocular and hematologic toxicity); and emerging mechanisms of ADC resistance. We also highlight future priorities, including MRD-directed, individualized adjuvant therapy and strategies to overcome resistance, to optimize ADC-based regimens for patients with suboptimal responses to standard treatment. ADCs should be positioned as a complement rather than a replacement for perioperative chemoimmunotherapy.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ying Xiong",
      "orcid": "0000-0001-6189-0148"
    },
    {
      "affs": [
        0
      ],
      "name": "Lu Sun",
      "orcid": "0000-0002-4658-4932"
    },
    {
      "affs": [
        0
      ],
      "name": "Yi Peng",
      "orcid": "0009-0008-0964-3500"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6v7bjb5sxs40d.bib",
  "cited_by": 0,
  "doi": "10.21037/tlcr-2026-1066",
  "fulltext_url": "https://europepmc.org/articles/PMC13743454",
  "id": "6v7bjb5sxs40d",
  "issns": [
    "2218-6751",
    "2226-4477"
  ],
  "landing_url": "https://europepmc.org/article/MED/42999616",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Lung Cancer Treatments and Mutations"
    ]
  ],
  "openalex": "W7223830030",
  "pdf_url": "https://europepmc.org/articles/PMC13743454?pdf=render",
  "pmcid": "PMC13743454",
  "pmid": "42999616",
  "published": "2026-09-28",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/6v7bjb5sxs40d.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:41Z",
      "native_id": "MED:42999616",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42999616"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2730|Lung Cancer Research Studies",
      "subfield": "oncology"
    }
  ],
  "title": "Antibody-drug conjugates in the perioperative treatment of resectable non-small cell lung cancer: a narrative review of research advances and prospects.",
  "title_text": "Antibody-drug conjugates in the perioperative treatment of resectable non-small cell lung cancer: a narrative review of research advances and prospects.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:41Z",
  "url": "https://research.draconitic.com/paper/6v7bjb5sxs40d",
  "venue": "Translational lung cancer research",
  "versions": []
}