New developments in locally advanced nonsmall cell lung cancer

Area of Science:

• Oncology
• Pulmonology
• Medical Imaging

Background:

• Locally advanced nonsmall cell lung cancer (NSCLC) presents heterogeneous prognoses across TNM stages IIIA, IIIB, and IIIC.
• Recent advancements focus on integrating immunotherapy with definitive local treatments (surgery, radiotherapy) and chemotherapy.

Purpose of the Study:

• To review current strategies and future directions in managing locally advanced NSCLC.
• To highlight the importance of personalized treatment approaches considering stage, biomarkers, and toxicity.

Main Methods:

• Review of recent developments in NSCLC treatment protocols.
• Emphasis on diagnostic tools like fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and mediastinal pathological evaluation.
• Investigation of immunological features and driver mutations in tumors.

Main Results:

• Consolidation therapy with durvalumab is established for concurrent chemoradiotherapy.
• Adjuvant targeted therapy is regaining significance.
• Evaluation of pulmonary and cardiac function, symptoms, and quality of life are crucial for toxicity assessment.

Conclusions:

• Personalized treatment adaptation based on TNM stage subgroup and prognosis is essential.
• Investigating tumors for immunological features and driver mutations can guide therapy.
• Clinical trials and registries must incorporate these factors to improve management and prognosis for locally advanced NSCLC.