Language barriers make it difficult for surgical teams to engage in the discussion of important aspects of pre- and post-operative patient care with patients who are non-Englishspeakers.

African Americans and Latinos face significant health disparities and institutional racism. Heart and lung disease are leading factors affecting morbidity and mortality in these groups. Notably, lung cancer is the number one killer of African Americans and number two killer of Latinos1,2. African Americans are also less likely to receive surgery for lung cancer than other groups3. As such, cardiothoracic surgeons are uniquely positioned to positively affect these health outcomes, mitigate racial health disparities, and contribute to the efforts towards health equity.

Healthcare disparities exist in surgicalmedicine and several factors contribute tothem, including the systemic effects ofstructural racism as well as implicit biascarried by providers. Complications arisingfrom harmful institutional structures, SocialDeterminants of Health, and lack of culturalcompetency are appropriately named“Cultural Complications.” In this paper, wereview the literature for strategies surgicalresidency programs have utilized to combatboth staff and patient exposure to CulturalComplications. In addition, we introduce thenovel UC Davis Department of Surgery’sCultural Complications M&M series.

Over the past decade, targeted therapy for oncogene-driven NSCLC and immune checkpoint inhibitors for non-oncogene-driven NSCLC, respectively, have greatly improved the survival and quality of life for patients with unresectable NSCLC. Increasingly, these biomarker-guided systemic therapies given before or after surgery have been used in patients with early-stage NSCLC. In March 2022, the US FDA granted the approval of neoadjuvant nivolumab and chemotherapy for patients with stage IB-IIIA NSCLC. Several phase II/III trials are evaluating the clinical efficacy of various neoadjuvant immune checkpoint inhibitor combinations for non-oncogene-driven NSCLC and neoadjuvant molecular targeted therapies for oncogene-driven NSCLC, respectively. However, clinical application of precision neoadjuvant treatment requires a paradigm shift in the biomarker testing and multidisciplinary collaboration at the diagnosis of early-stage NSCLC. In this comprehensive review, we summarize the current diagnosis and treatment landscape, recent advances, new challenges in biomarker testing and endpoint selections, practical considerations for a timely multidisciplinary collaboration at diagnosis, and perspectives in emerging neoadjuvant precision systemic therapy for patients with resectable, early-stage NSCLC. These biomarker-guided neoadjuvant therapies hold the promise to improve surgical and pathological outcomes, reduce systemic recurrences, guide postoperative therapy, and improve cure rates in patients with resectable NSCLC.

Lung cancer is the leading cause of cancer related deaths in the US, with 85% of cases classified as non-small cell lung cancer (NSCLC). 20-25% of patients with NSCLC present with resectable disease.

We created the PDX Network (PDXNet) portal (https://portal.pdxnetwork.org/) to centralize access to the National Cancer Institute-funded PDXNet consortium resources, to facilitate collaboration among researchers and to make these data easily available for research. The portal includes sections for resources, analysis results, metrics for PDXNet activities, data processing protocols and training materials for processing PDX data. Currently, the portal contains PDXNet model information and data resources from 334 new models across 33 cancer types. Tissue samples of these models were deposited in the NCI's Patient-Derived Model Repository (PDMR) for public access. These models have 2134 associated sequencing files from 873 samples across 308 patients, which are hosted on the Cancer Genomics Cloud powered by Seven Bridges and the NCI Cancer Data Service for long-term storage and access with dbGaP permissions. The portal includes results from freely available, robust, validated and standardized analysis workflows on PDXNet sequencing files and PDMR data (3857 samples from 629 patients across 85 disease types). The PDXNet portal is continuously updated with new data and is of significant utility to the cancer research community as it provides a centralized location for PDXNet resources, which support multi-agent treatment studies, determination of sensitivity and resistance mechanisms, and preclinical trials.