In Stage II to III non-small cell lung cancer (NSCLC), optimizing curative intent starts with selecting an appropriate treatment approach for your patient1
For Stage IIA (N0-N1), Stage IIB (N0-N2), Stage IIIA (N0-N2), or Stage IIIB (N2)
Surgery-based approach1,2*
Medically operable and resectable disease
All patients enrolled in Phase III, label-enabling trials had up-front resectable disease3-7
See the latest guidelines*For patients with Stage IIA (N0-N1), Stage IIB (N0-N2), Stage IIIA (N0-N2), or Stage IIIB (N2) disease, surgery is an option as part of a multimodal approach with neoadjuvant immunotherapy + CT, perioperative immunotherapy + neoadjuvant CT, or adjuvant immunotherapy or adjuvant therapies.1,2
+/- Neoadjuvant treatment
Surgery
+/- Adjuvant treatment
There should be a high probability of complete resection (R0) before initiation of a neoadjuvant approach. Neoadjuvant therapy to induce resectability is an unproven approach1†
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for NSCLC V.7.2026
†
High probability refers to the expectation that an R0 resection is feasible and achievable, as incomplete (R1/R2) resection is associated with poor outcomes.2
For unresectable Stage III disease
Chemoradiotherapy-based approach1,2‡
Medically inoperable or unresectable disease
See the latest guidelines‡For inoperable patients with unresectable Stage III disease, concurrent CRT followed by consolidation immunotherapy (or targeted therapy in the presence of certain mutations) is an option.1,2
Chemoradiotherapy
Consolidation treatment
MDT evaluation should be performed prior to treatment and should include a thoracic surgeon and a radiation oncologist who have major parts of their practices dedicated to thoracic oncology1
NCCN Guidelines® for NSCLC V.7.2026
In Stage II to III non-small cell lung cancer (NSCLC), optimizing curative intent starts with selecting an appropriate treatment approach for your patient1
For Stage IIA (N0-N1), Stage IIB (N0-N2), Stage IIIA (N0-N2), or Stage IIIB (N2)
Surgery-based approach1,2*
Medically operable and resectable disease
+/- Neoadjuvant treatment
Surgery
+/- Adjuvant treatment
All patients enrolled in Phase III, label-enabling trials had up-front resectable disease3-7
See the latest guidelines
*For patients with Stage IIA (N0-N1), Stage IIB (N0-N2), Stage IIIA (N0-N2), or Stage IIIB (N2) disease, surgery is an option as part of a multimodal approach with neoadjuvant immunotherapy + CT, perioperative immunotherapy + neoadjuvant CT, or adjuvant immunotherapy or adjuvant therapies.1,2
There should be a high probability of complete resection (R0) before initiation of a neoadjuvant approach. Neoadjuvant therapy to induce resectability is an unproven approach1†
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for NSCLC V.7.2026
†
High probability refers to the expectation that an R0 resection is feasible and achievable, as incomplete (R1/R2) resection is associated with poor outcomes.
For unresectable Stage III disease
Chemoradiotherapy-based approach1,2‡
Medically inoperable or unresectable disease
Chemoradiotherapy
Consolidation treatment
‡For inoperable patients with unresectable Stage III disease, concurrent CRT followed by consolidation immunotherapy (or targeted therapy in the presence of certain mutations) is an option.1,2
MDT evaluation should be performed prior to treatment and should include a thoracic surgeon and a radiation oncologist who have major parts of their practices dedicated to thoracic oncology1
NCCN Guidelines® for NSCLC V.7.2026
KEY POINTS
KEY POINTS
How can curative intent treatment be optimized in Stage II to III NSCLC?
- Optimizing curative intent starts with selecting an appropriate treatment approach for your patient1
- There are established pathways to curative intent, depending on medical operability and resectability: The surgery-based approach and the chemoradiotherapy-based approach1,2
- Early assessment by the full multidisciplinary team is critical for identifying an appropriate curative intent approach for each patient1
CRT=chemoradiotherapy; CT=chemotherapy; MDT=multidisciplinary team; NCCN=National Comprehensive Cancer Network® (NCCN®).
References: 1. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer V.7.2026. © National Comprehensive Cancer Network, Inc. 2026. All rights reserved. Accessed August 7, 2026. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. 2. Kim SS, Cooke DT, Kidane B, et al. The Society of Thoracic Surgeons expert consensus on the multidisciplinary management and resectability of locally advanced non-small cell lung cancer. Ann Thorac Surg. 2025;119(1):16-33. 3. Cascone T, Awad MM, Spicer JD, et al. Perioperative nivolumab in resectable lung cancer. N Engl J Med. 2024;390(19):1756-1769. 4. Lu S, Zhang W, Wu L, et al. Perioperative toripalimab plus chemotherapy for patients with resectable non–small cell lung cancer: the Neotorch randomized clinical trial. JAMA. 2024;331(3):201-211. 5. Heymach JV, Harpole D, Mitsudomi T, et al. Perioperative durvalumab for resectable non–small-cell lung cancer. N Engl J Med. 2023;389(18):1672-1684. 6. Wakelee H, Liberman M, Kato T, et al. Perioperative pembrolizumab for early-stage non–small-cell lung cancer. N Engl J Med. 2023;389(6):491-503. 7. Forde PM, Spicer J, Lu S, et al. Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer. N Engl J Med. 2022;386(21):1973-1985.
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