Traitement standard des stades III non résécables: Standard therapy for unresectable Stage III Non-Small Cell Lung Cancer

Abstract

Approximately 25% of Non-small Cell Lung Cancer (NSCLC) present with a locally advanced disease. Stage III NSCLC includes heterogeneous diseases in term of initial clinical presentation and therapeutic strategy. An optimal initial staging integrating a PET/CT, EBUS mediastinal nodes exploration and an injected brain imaging is necessary. Pulmonary function test is to be systematically realized. The therapeutic strategy is decided in a multidisciplinary tumor board by an experimented team. Most of the stage IIIB and IIIC NSCLC receive a radio-chemotherapy. A concurrent plan is to be favored to a sequential plan. Platinum doublets comprise most standard chemotherapy regimens and must be started as early as possible. For fail or elderly patients who could not benefit from a concurrent chemotherapy, a sequential normo-fractionnated radiotherapy, or even a single chemotherapy are possible alternatives. After radio-chemotherapy, a consolidation systemic treatment by durvalumab, a checkpoint inhibitor, is currently a standard of care, in patients with a PD-L1 expressing tumor, based on the PACIFIC trial overall survival results.1877-1203/© 2023 SPLF. Published by Elsevier Masson SAS. All rights reserved.