[Current standards for the management of locally advanced unresectable non small cell lung cancer]

Non-small cell lung cancers (NSCLC) account for 85 % of bronchopulmonary cancers and are most often diagnosed at an advanced stage. In case of resectable locally advanced NSCLC (LA-NSCLC) in a patient fit, surgery is the cornerstone of treatment in combination with perioperative treatment based on chemotherapy +/- immunotherapy. However, for a large proportion of LA-NSCLC, surgery is not a preferred option because the patient is medically inoperable or because of an unresectable disease. Since the early 2000s, the standard treatment for these patients who cannot benefit from surgical treatment had been a chemoradiotherapy, ideally given concurrently. The recent addition of consolidation immunotherapy following concurrent chemoradiotherapy has led to a clear improvement in median overall survival (OS) in this population. The objective of this article is to detail the standard treatment in 2024 of unresectable (or inoperable) LA-NSCLC and to discuss the main therapeutic perspectives in this indication, both regarding radiotherapy and systemic treatment and especially combination strategies with immunotherapy.