Locally advanced non–small cell lung cancer: What is the optimal concurrent chemoradiation regimen?

2012 ◽  
Vol 79 (5 e-suppl 1) ◽  
pp. S32-S37 ◽  
Author(s):  
Gregory M.M. Videtic
Author(s):  
Kristin A. Higgins ◽  
Sonam Puri ◽  
Jhanelle E. Gray

The treatment for locally advanced non–small-cell lung cancer has changed dramatically over the past several years, with consolidative immunotherapy after concurrent chemoradiation becoming the new standard of care. Five-year survival outcomes have substantially improved with this approach. Despite these advances, further improvements are needed as the majority of patients ultimately develop progression of disease. The next-generation immunotherapy trials are currently being conducted that include approaches such as concurrent immunotherapy and addition of other therapeutic agents in the concurrent and consolidative settings. Specific unmet needs continue to exist for patients who develop disease progression after concurrent chemoradiation and immunotherapy, as well as defining the best treatment for patients with driver mutations. Future directions also include refinement of radiation techniques to reduce toxicities as much as possible, as well as the use of circulating tumor DNA in the surveillance setting. The current scientific landscape shows promising approaches that may further improve outcomes for patients with locally advanced non–small-cell lung cancer.


2012 ◽  
Vol 08 (01) ◽  
pp. 24 ◽  
Author(s):  
Christine Collen ◽  
Denis Schallier ◽  
Mark De Ridder ◽  
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◽  
...  

Clinicians are faced with the challenge of treating increasing numbers of elderly patients with locally advanced non-small cell lung cancer (LA-NSCLC) and co-morbid conditions. The benefit of combined chemoradiation in the younger patient using the concurrent modality compared with the sequential administration of both modalities has been established in several randomised trials and recent meta-analyses. Because of the underrepresentation of elderly patients in clinical trials on concurrent chemoradiation (CCRT) in LA-NSCLC, treatment guidelines for this age group are not well established. The objective of this report is to summarise the data on efficacy and toxicity of CCRT in the elderly.


2020 ◽  
pp. 209-214
Author(s):  
N. V. Marinichenko ◽  
K. K. Laktionov ◽  
A. V. Nazarenko ◽  
E. V. Reutova ◽  
Merab S. Ardzinba ◽  
...  

For more than 10 years, there have been no significant improvements in treatment outcomes for patients with inoperable locally advanced non-small cell lung cancer. At the moment, the standard of treatment for this category of patients is concurrent chemoradiation therapy. At the same time, the 5-year overall survival rate varies in the range of 15–25%. This indicator contributes to the modernization of existing approaches, as well as the search for new ways in the treatment of patients with inoperable stage III non-small cell lung cancer.One of the promising areas is the combination of chemoradiation therapy with immunotherapy. Thus, the use of Imfinzi (durvalumab, AstraZeneca) as a consolidation therapy in the Phase III clinical trial PACIFIC demonstrated a reduction in the risk of death by about one third in comparison with the standard approach.We present a clinical case study of a patient with locally advanced non-small cell lung cancer who received treatment in the framework of concurrent chemoradiation therapy followed by immunotherapy with durvalumab, continuing until now. The result of the therapy is the complete response to the specific treatment, recorded according to PET-CT.Thus, the use of immunotherapy as consolidation therapy represents a promising strategy for improving outcomes after concurrent chemoradiation therapy in patients with inoperable stage III non-small cell lung cancer


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