Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Jul 8;28(152):190024.
doi: 10.1183/16000617.0024-2019. Print 2019 Jun 30.

Interdisciplinary multimodality management of stage III nonsmall cell lung cancer

Affiliations
Review

Interdisciplinary multimodality management of stage III nonsmall cell lung cancer

Rudolf M Huber et al. Eur Respir Rev. .

Abstract

Stage III nonsmall cell lung cancer (NSCLC) comprises about one-third of NSCLC patients and is very heterogeneous with varying and mostly poor prognosis. It is also called "locoregionally or locally advanced disease". Due to its heterogeneity a general schematic management approach is not appropriate. Usually a combination of local therapy (surgery or radiotherapy, depending on functional, technical and oncological operability) with systemic platinum-based doublet chemotherapy and, recently, followed by immune therapy is used. A more aggressive approach of triple agent chemotherapy or two local therapies (surgery and radiotherapy, except for specific indications) has no benefit for overall survival. Until now tumour stage and the general condition of the patient are the most relevant prognostic factors. Characterising the tumour molecularly and immunologically may lead to a more personalised and effective approach. At the moment, after an exact staging and functional evaluation, an interdisciplinary discussion amongst the tumour board is warranted and offers the best management strategy.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: R.M. Huber reports personal fees from AstraZeneca (Germany), Boehringer Ingelheim (Germany), BMS (Germany), Lilly, Pfizer (Germany), Roche (Germany), Takeda and MSD (Germany), outside the submitted work. Conflict of interest: D. De Ruysscher reports grants and other funding from BMS and AstraZeneca, and other funding from Roche/Genentech, Merck/Pfizer and Celgene, during the conduct of the study. Conflict of interest: H. Hoffmann has nothing to disclose. Conflict of interest: S. Reu has nothing to disclose. Conflict of interest: A. Tufman reports personal fees from Boehringer Ingelheim, Lilly, Roche and Chugai, outside the submitted work.

Figures

FIGURE 1
FIGURE 1
Principal management of patients with nonsmall cell lung cancer (NSCLC) in stage III. PET-CT: positron emission tomography-computed tomography; EBUS: endobronchial ultrasound.

References

    1. Detterbeck FC, Boffa DJ, Kim AW, et al. . The eighth edition lung cancer stage classification. Chest 2017; 151: 193–203. - PubMed
    1. Goldstraw P, Chansky K, Crowley J, et al. . The IASLC Lung Cancer Staging Project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol 2016; 11: 39–51. - PubMed
    1. Postmus PE, Kerr KM, Oudkerk M, et al. . Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2017; 28: Suppl. 4, iv1–iv21. - PubMed
    1. Kris MG, Gaspar LE, Chaft JE, et al. . Adjuvant systemic therapy and adjuvant radiation therapy for stage I to IIIa completely resected non–small-cell lung cancers: American Society of Clinical Oncology/Cancer Care Ontario Clinical Practice Guideline Update. J Clin Oncol 2017; 35: 2960–2974. - PubMed
    1. De Ruysscher D, Vansteenkiste J, Belderbos J, et al. . The optimal local treatment of stage IIIA-N2 non-small cell lung cancer: is the issue finally settled? J Thorac Oncol 2016; 11: 284–246. - PubMed

MeSH terms