Unresectable stage III non-small-cell lung cancer: state of the art and challenges.

Journal: Nature reviews. Clinical oncology

This review addresses the evolving management of unresectable stage III non-small-cell lung cancer (NSCLC), highlighting the current standard of care established by the PACIFIC trial, which uses durvalumab consolidation after chemoradiotherapy.

It also discusses the LAURA trial’s impact on EGFR-mutant NSCLC, showing significant progression-free survival benefits with osimertinib consolidation.

The article emphasizes the urgent need for novel strategies, including:

  • Circulating tumor DNA-based minimal residual disease monitoring to personalize treatment,
  • Advanced radiotherapy techniques aimed at enhancing immunotherapy synergy while reducing toxicity,
  • Ongoing trials exploring chemoimmunotherapy combinations that could potentially convert unresectable cases to surgical candidates.

The review also covers biomarkers, therapy personalization, and the role of immunotherapy rechallenge in this difficult-to-treat population.

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