Perspectives thérapeutiques dans la prise en charge des CBNPC de stade III non résécables: Therapeutic advances for the management of unresectable stage III Non-Small Cell Lung Cancer

Abstract

Until 2017, the standard of care for unresectable stage III Non-Small Cell Lung Cancer (NSCLC) was a combination of radiotherapy and chemotherapy, ideally concomitantly. The main advance in recent years has been the addition of consolidation immunotherapy with durvalumab, following chemoradiotherapy, allowing to achieve an unprecedentedly 5-year survival rate of more than 40%. This now well-established standard still needs to be improved. The current therapeutic perspectives relate to the optimization of the technical modalities of radiotherapy, and especially dose escalation strategies and the integration of metabolic imaging as part of an adaptive approach. These advances have not yet translated into clear clinical benefit, and must be refined in order to benefit patients. On the other hand, the optimization of strategies for combining radiotherapy and systemic treatments, and particularly immunotherapy, is a major challenge for the future. The combination of the different approaches could be necessary in order to improve the outcome of these patients.1877-1203/© 2023 SPLF. Published by Elsevier Masson SAS. All rights reserved.