Management of locally advanced non-small cell lung cancer: State of the art and future directions
Da Miao,
Jing Zhao,
Ying Han,
Jiaqi Zhou,
Xiuzhen Li,
Ting Zhang,
Wen Li,
Yang Xia,
Da Miao
Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Department of Oncology, Shaoxing Second Hospital, Shaoxing, Zhejiang, P. R. China
Search for more papers by this authorJing Zhao
Department of Medical Oncology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Search for more papers by this authorYing Han
Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Department of Chemoradiotherapy, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, P. R. China
Search for more papers by this authorJiaqi Zhou
Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Key Discipline of Jiaxing Respiratory Medicine Construction Project, Jiaxing Key Laboratory of Precision Treatment for Lung Cancer, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, P. R. China
Search for more papers by this authorXiuzhen Li
Department of Pathology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Search for more papers by this authorTing Zhang
Department of Radiation Oncology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Search for more papers by this authorWen Li
Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Cancer Center, Zhejiang University, Hangzhou, Zhejiang, P. R. China
Search for more papers by this authorCorresponding Author
Yang Xia
Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Cancer Center, Zhejiang University, Hangzhou, Zhejiang, P. R. China
Correspondence:
Yang Xia, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310052, P. R. China.
Email: [email protected]
Search for more papers by this authorDa Miao,
Jing Zhao,
Ying Han,
Jiaqi Zhou,
Xiuzhen Li,
Ting Zhang,
Wen Li,
Yang Xia,
Da Miao
Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Department of Oncology, Shaoxing Second Hospital, Shaoxing, Zhejiang, P. R. China
Search for more papers by this authorJing Zhao
Department of Medical Oncology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Search for more papers by this authorYing Han
Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Department of Chemoradiotherapy, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, P. R. China
Search for more papers by this authorJiaqi Zhou
Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Key Discipline of Jiaxing Respiratory Medicine Construction Project, Jiaxing Key Laboratory of Precision Treatment for Lung Cancer, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, P. R. China
Search for more papers by this authorXiuzhen Li
Department of Pathology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Search for more papers by this authorTing Zhang
Department of Radiation Oncology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Search for more papers by this authorWen Li
Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Cancer Center, Zhejiang University, Hangzhou, Zhejiang, P. R. China
Search for more papers by this authorCorresponding Author
Yang Xia
Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
Cancer Center, Zhejiang University, Hangzhou, Zhejiang, P. R. China
Correspondence:
Yang Xia, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310052, P. R. China.
Email: [email protected]
Search for more papers by this authorDa Miao and Jing Zhao contributed equally to this work.
Abstract
Lung cancer is the second most common and the deadliest type of cancer worldwide. Clinically, non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer; approximately one-third of affected patients have locally advanced NSCLC (LA-NSCLC, stage III NSCLC) at diagnosis. Because of its heterogeneity, LA-NSCLC often requires multidisciplinary assessment. Moreover, the prognosis of affected patients is much below satisfaction, and the efficacy of traditional therapeutic strategies has reached a plateau. With the emergence of targeted therapies and immunotherapies, as well as the continuous development of novel radiotherapies, we have entered an era of novel treatment paradigm for LA-NSCLC. Here, we reviewed the landscape of relevant therapeutic modalities, including adjuvant, neoadjuvant, and perioperative targeted and immune strategies in patients with resectable LA-NSCLC with/without oncogenic alterations; as well as novel combinations of chemoradiation and immunotherapy/targeted therapy in unresectable LA-NSCLC. We addressed the unresolved challenges that remain in the field, and examined future directions to optimize clinical management and increase the cure rate of LA-NSCLC.
CONFLICT OF INTEREST STATEMENT
All authors declare that they have no competing interests.
Open Research
DATA AVAILABILITY STATEMENT
Not applicable.
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