Interdisciplinary multimodality management of stage III nonsmall cell lung cancer

Rudolf M Huber, Dirk De Ruysscher, Hans Hoffmann, Simone Reu, Amanda Tufman, Rudolf M Huber, Dirk De Ruysscher, Hans Hoffmann, Simone Reu, Amanda Tufman

Abstract

Stage III nonsmall cell lung cancer (NSCLC) comprises about one-third of NSCLC patients and is very heterogeneous with varying and mostly poor prognosis. It is also called "locoregionally or locally advanced disease". Due to its heterogeneity a general schematic management approach is not appropriate. Usually a combination of local therapy (surgery or radiotherapy, depending on functional, technical and oncological operability) with systemic platinum-based doublet chemotherapy and, recently, followed by immune therapy is used. A more aggressive approach of triple agent chemotherapy or two local therapies (surgery and radiotherapy, except for specific indications) has no benefit for overall survival. Until now tumour stage and the general condition of the patient are the most relevant prognostic factors. Characterising the tumour molecularly and immunologically may lead to a more personalised and effective approach. At the moment, after an exact staging and functional evaluation, an interdisciplinary discussion amongst the tumour board is warranted and offers the best management strategy.

Conflict of interest statement

Conflict of interest: R.M. Huber reports personal fees from AstraZeneca (Germany), Boehringer Ingelheim (Germany), BMS (Germany), Lilly, Pfizer (Germany), Roche (Germany), Takeda and MSD (Germany), outside the submitted work. Conflict of interest: D. De Ruysscher reports grants and other funding from BMS and AstraZeneca, and other funding from Roche/Genentech, Merck/Pfizer and Celgene, during the conduct of the study. Conflict of interest: H. Hoffmann has nothing to disclose. Conflict of interest: S. Reu has nothing to disclose. Conflict of interest: A. Tufman reports personal fees from Boehringer Ingelheim, Lilly, Roche and Chugai, outside the submitted work.

Copyright ©ERS 2019.

Figures

FIGURE 1
FIGURE 1
Principal management of patients with nonsmall cell lung cancer (NSCLC) in stage III. PET-CT: positron emission tomography-computed tomography; EBUS: endobronchial ultrasound.

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Source: PubMed

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