The evolution of non-surgical management in stage III non-small cell lung cancer

The management of unresectable stage III non-small cell lung cancer (NSCLC) continues to evolve with the integration of immunotherapy and targeted agents into treatment paradigms. The PACIFIC trial established consolidation durvalumab following concurrent chemoradiotherapy (CRT) as the standard of care in many settings. However, emerging evidence challenges the one-size-fits-all approach, particularly for molecularly defined subsets and specific patient populations. This debate article examines the evolving landscape of non-surgical stage III NSCLC management, presenting evidence-based arguments for refining treatment strategies based on molecular biomarkers, novel immunotherapy combinations, and alternative sequencing approaches.