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.
Abstract
Stage III NSCLC is a heterogenous group. Outcome depends on a good inter- and multidisciplinary strategy. Local treatment and systemic therapy both have to be optimised. Interdisciplinary trials integrate systemic targeted therapy or immunotherapy. bit.ly/2WstXtX
Footnotes
Provenance: Submitted article, peer reviewed.
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.
- Received March 11, 2019.
- Accepted May 24, 2019.
- Copyright ©ERS 2019.
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