Stage III NSCLC treatment options: too many choices
Oke Dimas Asmara,
Georgia Hardavella,
Sara Ramella,
René Horsleben Petersen,
Ilona Tietzova,
E. Christiaan Boerma,
Eric Daniel Tenda,
Asmaa Bouterfas,
Marjolein A. Heuvelmans,
Wouter H. van Geffen
Affiliations
Oke Dimas Asmara
Department of Respiratory Medicine, Medical Central Leeuwarden, Leeuwarden, The Netherlands
Georgia Hardavella
4th–9th Department of Respiratory Medicine, “Sotiria” Athens’ Chest Diseases Hospital, Athens, Greece
Sara Ramella
Operative Research Unit of Radiation Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
René Horsleben Petersen
Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
Ilona Tietzova
1st Department of Tuberculosis and Respiratory Diseases, First Faculty of Medicine, Charles University, Prague, Czech Republic
E. Christiaan Boerma
Department of Sustainable Health, Faculty Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands
Eric Daniel Tenda
Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Asmaa Bouterfas
Pulmonology Department, Clinique Pasteur, Toulouse, France
Marjolein A. Heuvelmans
Department of Respiratory Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
Wouter H. van Geffen
Department of Respiratory Medicine, Medical Central Leeuwarden, Leeuwarden, The Netherlands
Stage III nonsmall cell lung cancer (NSCLC) represents a wide range of tumour (T1 to T4) and nodal (N0 to N3) components, requiring variable management and a multidisciplinary approach. Recent advancements in minimally invasive techniques, molecular biology and novel drug discoveries have accelerated the refinement of stage III NSCLC management. The latest developments in staging include the forthcoming update of the nodal component in the 9th TNM (tumour–node–metastasis) edition, which emphasises the critical role for endobronchial ultrasonography in mediastinal staging. Recent treatment developments include the use of immunotherapy and targeted molecular therapy in both the neoadjuvant and adjuvant setting, either in combination with other modalities or used alone as consolidation. Surgical and radiotherapy advancements have further enhanced patient outcomes. These developments have significantly improved the prognosis for patients with stage III NSCLC. Fast-changing recommendations have also brought about a challenge, with clinicians facing a number of options to choose from. Therefore, a multimodal approach by a multidisciplinary team has become even more crucial in managing stage III NSCLC.
