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Review
. 2025 Apr:135:102918.
doi: 10.1016/j.ctrv.2025.102918. Epub 2025 Mar 11.

The evolving landscape of stage III unresectable non-small cell lung cancer "between lights and shadows"

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Free article
Review

The evolving landscape of stage III unresectable non-small cell lung cancer "between lights and shadows"

Marco Donatello Delcuratolo et al. Cancer Treat Rev. 2025 Apr.
Free article

Abstract

Despite PACIFIC set a new milestone in the clinical management of unresectable stage III non-small cell lung cancer (NSCLC), it left some critical questions pending for clinical research: the efficacy of durvalumab in the real-world setting; the activity of less intensive regimens for frail populations; the role of targeted therapies in oncogene-addicted tumors; the selection of subsequent strategies at immunotherapy failure; the efficacy of novel and intensified treatments; the role of molecular biomarkers for patients' selection. This review aims to describe the evolving landscape of unresectable stage III NSCLC and provides an updated overview of the available evidence, analyzing lights and shadows emerging from recent clinical trials and discussing the most relevant challenges of post-PACIFIC era.

Keywords: Immunotherapy; Locally advanced; Non-small cell lung cancer; Unresectable; stage III.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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