Standard Treatment Option in Stage III Non–Small-Cell Lung Cancer: Case Against Trimodal Therapy and Consolidation Drug Therapy

Jeremić, Branislav

doi:10.1016/j.cllc.2014.08.003

Cited by 12 publications

(6 citation statements)

References 57 publications

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“…For those patients who have received combination modality approach, including chemotherapy, radiation, and/or surgery, the current 5-year survival rate for stage III NSCLC is approximately 20-25% [5,6]. Many patients already have an advanced form of NSCLC when they are first diagnosed, for patients with clinically or pathologically staged III-N2 operable NSCLC, there is still a considerable debate among many organizations and cooperative groups regarding the best strategy of comprehensive treatment [7]. As a consequence, the standard treatment options for patients with resectable stage III-N2 NSCLC remain controversial.…”

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confidence: 99%

The effect of postoperative radiotherapy on the survival of patients with resectable stage III-N2 non-small-cell lung cancer: a systematic review and meta-analysis

Zhang

et al. 2019

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In the potentially resectable cases of stage III-N2 non-small-cell lung cancer (NSCLC), the optimal post-operative treatment regimen for these patients is uncertain and post-operative radiation therapy (PORT) with chemotherapy is typically recommended. Our aim was to reassess the data of PORT on overall survival (OS) and disease-free survival (DFS) in stage III-N2 NSCLC, in order to figure out whether PORT might lead to a moderate improvement in local control and survival besides resection and adjuvant chemotherapy. A comprehensive search strategy was performed in EMBASE, PubMed, and Cochrane Library for relevant studies comparing PORT combined with adjuvant chemotherapy or adjuvant chemotherapy alone on OS and DFS in resectable stage III-N2 NSCLC. Data were extracted to estimate the effects of PORT on OS and DFS. Eleven studies with 8,928 patients were included. This meta-analysis demonstrated a trend in improving OS associated with the use of PORT (HR=0.88; 95% CI, 0.76 to 1.03; p=0.11) and a significantly difference of effect on DFS associated with the use of PORT (HR=0.78; 95% CI, 0.66 to 0.92; p=0.003). In a subgroup analysis on Caucasian patients, there was a statistically significant benefit (HR=0.88; 95% CI, 0.81 to 0.96; p=0.003) on OS for PORT. Our findings demonstrate that in the postoperative treatment for patients with stage III-N2 NSCLC, PORT is associated with improved OS and leads to a significantly increased DFS.

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confidence: 99%

The effect of postoperative radiotherapy on the survival of patients with resectable stage III-N2 non-small-cell lung cancer: a systematic review and meta-analysis

Zhang

et al. 2019

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“…The chemotherapy component typically involves one of three regimens: cisplatin-etoposide, cisplatin-vinorelbine, or carboplatin-paclitaxel 5 . Consolidative chemotherapy does not appear to improve survival after concurrent chemoradiotherapy 49 . Although treatment for metastatic nsclc has evolved markedly since 2009, no major advances in systemic therapy for stage iii nsclc had been made until the pacific trial.…”

Section: Stage III Nsclcmentioning

confidence: 96%

Immuno-Oncology—The New Paradigm of Lung Cancer Treatment

2020

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Systemic therapy is an essential part of treatment for all patients with small-cell lung cancer (sclc) and for most patients with non-small-cell lung cancer (nsclc). Standards of care have evolved dramatically since 2009, especially in the setting of incurable or advanced nsclc. Part of that evolution has been the incorporation of immuno-oncology drugs, especially immune checkpoint inhibitors (icis) into multiple therapeutic scenarios. In the present review, we discuss the role of the immune system in lung cancer and the previous failures of immunotherapy for patients with lung cancer. We then provide an overview of the existing evidence for the use of icis in patients with advanced nsclc that is either treatment-naïve or pretreated, for consolidative treatment after chemoradiotherapy in stage iii nsclc, and for palliative therapy in patients with sclc. Finally, we discuss duration of treatment, special populations, and the future of immuno-oncology for patients with lung cancer. Overall, we provide an evidence-based snapshot of immuno-oncology agents in the treatment of lung cancer up to early 2019.

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“…If so, then it would be fair to say that there is not a single piece of strong evidence supporting the use of trimodality therapy in this setting. 5 Although we do not exclude the possibility that there may be a subset of patients benefitting from it, it is currently unknown as to which patients we are speaking about as there is a tremendous lack of data supporting it. As a matter of fact, there are no studies attempting to identify potential predictors of the superiority of trimodality therapy, and furthermore, there is also a huge inconsistency in the findings of the poor literature addressing the issue of potential pretreatment prognostic factors in this setting.…”

Section: To the Editormentioning

confidence: 96%