Management of locally advanced non‐small cell lung cancer: State of the art and future directions

Author:

Miao Da12,Zhao Jing3,Han Ying14,Zhou Jiaqi15,Li Xiuzhen6,Zhang Ting7,Li Wen18,Xia Yang18ORCID

Affiliation:

1. Key Laboratory of Respiratory Disease of Zhejiang Province Department of Respiratory and Critical Care Medicine Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou Zhejiang P. R. China

2. Department of Oncology Shaoxing Second Hospital Shaoxing Zhejiang P. R. China

3. Department of Medical Oncology Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou Zhejiang P. R. China

4. Department of Chemoradiotherapy The Affiliated People's Hospital of Ningbo University Ningbo Zhejiang P. R. China

5. Key Discipline of Jiaxing Respiratory Medicine Construction Project Jiaxing Key Laboratory of Precision Treatment for Lung Cancer Affiliated Hospital of Jiaxing University Jiaxing Zhejiang P. R. China

6. Department of Pathology Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou Zhejiang P. R. China

7. Department of Radiation Oncology Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou Zhejiang P. R. China

8. Cancer Center Zhejiang University Hangzhou Zhejiang P. R. China

Abstract

AbstractLung cancer is the second most common and the deadliest type of cancer worldwide. Clinically, non‐small cell lung cancer (NSCLC) is the most common pathological type of lung cancer; approximately one‐third of affected patients have locally advanced NSCLC (LA‐NSCLC, stage III NSCLC) at diagnosis. Because of its heterogeneity, LA‐NSCLC often requires multidisciplinary assessment. Moreover, the prognosis of affected patients is much below satisfaction, and the efficacy of traditional therapeutic strategies has reached a plateau. With the emergence of targeted therapies and immunotherapies, as well as the continuous development of novel radiotherapies, we have entered an era of novel treatment paradigm for LA‐NSCLC. Here, we reviewed the landscape of relevant therapeutic modalities, including adjuvant, neoadjuvant, and perioperative targeted and immune strategies in patients with resectable LA‐NSCLC with/without oncogenic alterations; as well as novel combinations of chemoradiation and immunotherapy/targeted therapy in unresectable LA‐NSCLC. We addressed the unresolved challenges that remain in the field, and examined future directions to optimize clinical management and increase the cure rate of LA‐NSCLC.

Publisher

Wiley

Subject

Cancer Research,Oncology

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