New developments in locally advanced nonsmall cell lung cancer

Eur Respir Rev. 2021 May 5;30(160):200227. doi: 10.1183/16000617.0227-2020. Print 2021 Jun 30.

Abstract

Locally advanced nonsmall cell lung cancer, due to its varying prognosis, is grouped according to TNM stage IIIA, IIIB and IIIC. Developments over the last 3 years have been focused on the integration of immunotherapy into the combination treatment of a locally definitive therapy (surgery or radiotherapy) and chemotherapy. For concurrent chemoradiotherapy, consolidation therapy with durvalumab was established. Adjuvant targeted therapy has again gained increasing interest. In order to adapt treatment to the specific stage subgroup and its prognosis, fluorodeoxyglucose positron emission tomography/computed tomography and pathological evaluation of the mediastinum are important. Tumours should be investigated for immunological features and driver mutations. Regarding toxicity, evaluation of pulmonary and cardiac function, as well as symptoms and quality of life, is of increasing importance. To improve the management and prognosis of this heterogeneous entity, clinical trials and registries should take these factors into account.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Carcinoma, Non-Small-Cell Lung* / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Carcinoma, Non-Small-Cell Lung* / genetics
  • Chemoradiotherapy
  • Combined Modality Therapy
  • Humans
  • Lung Neoplasms* / diagnostic imaging
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / genetics
  • Neoplasm Staging
  • Quality of Life