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Published on: February 12, 2017
The treatment in patients with unresectable locally advanced non-small cell lung cancer: Explorations on hot issues
Yimeng Wang1, Yao Wang1, Jinming Yu2
1Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong First Medical University, Jinan, China.
Abstract:
The treatment efficacy for patients with unresectable, locally advanced non-small-cell lung cancer (LA-NSCLC) stagnated for a long time until the advent of immunotherapy. Immune checkpoint inhibitors, particularly programmed cell death protein 1/programmed death-ligand 1 inhibitors, have thrived, reshaping the treatment landscape for patients with lung cancer. Based on the results of the PACIFIC trial, concurrent chemoradiotherapy followed by durvalumab has become the standard of care for patients with unresectable LA-NSCLC; however, numerous issues are yet to be resolved. Currently, several clinical trials are exploring an optimal treatment paradigm, and we have summarized them for comparison to eliminate barriers. In addition, we discuss better predictive biomarkers, therapeutic options for specific populations, and other challenges to identify directions for future research design.
Insights
Immunotherapy, including PD-1/PD-L1 inhibitors, has advanced lung cancer treatment. Concurrent chemoradiotherapy with durvalumab is standard for unresectable non-small-cell lung cancer, but future research is needed.
Area of Science:
- Oncology
- Immunotherapy
- Thoracic Surgery
Background:
- Treatment for unresectable, locally advanced non-small-cell lung cancer (LA-NSCLC) has significantly improved with immunotherapy.
- Immune checkpoint inhibitors (ICIs), specifically targeting programmed cell death protein 1 (PD-1) and programmed death-ligand 1 (PD-L1), have transformed lung cancer therapy.
Purpose of the Study:
- To review current clinical trials investigating optimal treatment paradigms for unresectable LA-NSCLC.
- To discuss unresolved issues, predictive biomarkers, and therapeutic strategies for specific patient populations in LA-NSCLC treatment.
Main Methods:
- Review of clinical trial data and existing literature on immunotherapy for LA-NSCLC.
- Comparative analysis of ongoing clinical trials to identify treatment barriers and future directions.
Main Results:
- Concurrent chemoradiotherapy followed by durvalumab is the established standard of care for unresectable LA-NSCLC, based on PACIFIC trial outcomes.
- Several clinical trials are actively exploring novel treatment strategies and optimizing existing paradigms.
Conclusions:
- Despite advancements, challenges remain in LA-NSCLC treatment, necessitating further research.
- Identifying predictive biomarkers and tailored therapeutic options is crucial for improving outcomes in specific patient groups.
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