Local treatment of stage IIIA-N2 nonsmall cell lung cancer: surgery and/or radiotherapy

Purpose of review Controversy exists regarding the optimal treatment of patients with stage IIIA-N2 nonsmall cell lung cancer because of its heterogeneity. Patients are at risk for both local and distant disease relapse after primary local treatment. However, there may be a window of opportunity for surgery, if mediastinal downstaging has been obtained after induction therapy. This manuscript reviews the outcome of patients treated by neo-adjuvant chemotherapy (NA-C) followed by surgery, compared with patients treated with either definitive sequential or concurrent chemoradiotherapy (cCRT), illustrated by a single-centre retrospective case series. Recent findings Of 53 eligible patients, 19 received NA-C and underwent surgical resection, whilst 20 and 14 received concurrent or sequential definitive CRT, respectively. A significant difference in progression-free survival favouring NA-C followed by surgery over both CRT modalities was found. However, this translated only in an overall survival benefit in comparison with sequential definitive CRT. A trend for better outcome was observed in selected surgical patients with single-level mediastinal involvement and complete resection. Summary Our case series results are consistent with the present standard of care of CRT, which restricts surgical resection to carefully selected patients. Immunotherapy will likely change the treatment paradigm.
Source: Current Opinion in Oncology - Category: Cancer & Oncology Tags: LUNG AND MEDIASTINUM: Edited by Robert Pirker Source Type: research

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Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
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Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
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Source: Seminars in Cancer Biology - Category: Cancer & Oncology Source Type: research
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Source: Thoracic Cancer - Category: Cancer & Oncology Authors: Tags: CASE REPORT Source Type: research
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Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - Category: Drugs & Pharmacology Authors: Tags: REVIEW OF THERAPEUTICS Source Type: research
Authors: Li S, Zhang S, Liu J, Yang C, Zhang L, Cheng Y Abstract Background: This meta-analysis evaluated the efficacy of PD-L1/PD-1 immunotherapy compared with chemotherapy in IIIB or IV or recurrent squamous non-small cell lung cancer (NSCLC) patients. Methods: We performed a literature search on the PubMed, EMBASE, Web of Science, and Cochrane databases, in addition to the abstracts from major conference proceedings of the European Society for Medical Oncology (ESMO), the American Society of Clinical Oncology (ASCO), and the World Conference on Lung Cancer (WCLC) from 2004 to May 2019. Randomized controlled ...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
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Source: Drugs - Category: Drugs & Pharmacology Source Type: research
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Source: Nature Reviews Clinical Oncology - Category: Cancer & Oncology Authors: Source Type: research
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Source: Lung Cancer - Category: Cancer & Oncology Authors: Source Type: research
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Source: Cytotherapy - Category: Cytology Source Type: research
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