Until recently, the standard treatment in unresectable stage III non-small cell lung cancer was concurrent chemoradiotherapy, but often with dismal outcome. The introduction of consolidation treatment with immune checkpoint inhibitors has shifted the treatment landscape and prognosis of these patients. However, patients whose tumors harbors an epidermal growth factor receptor (EGFR) mutation derived less benefit, with an increased risk of immune-related adverse events. Moreover, current data suggested that patients with oncogenic addicted tumors, mainly -positive tumors, and also anaplastic lymphoma kinase ()-positive have poorer progression free survival after chemoradiotherapy. Indeed, these tumors have also inferior distant control compared with those who have wild-type disease, especially in the central nervous system, highlighting the need for assessing the role of targeted therapies in this patient population. It is speculated that outcome could probably increase with a consolidation treatment strategy including an EGFR tyrosine kinase inhibitor. However, a personalized treatment approach is not considered standard of care in this setting due to lack of robust evidence, as the majority of trials were performed in unselected patients, number of patients is limited and the majority of these studies were underpowered. In this review we summarize the role of tyrosine kinase inhibitors in unresectable stage III NSCLC, specifically focusing on -mutant tumors.
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http://dx.doi.org/10.21037/med-21-8 | DOI Listing |
Cancer Treat Res Commun
January 2025
Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region, Hong Kong.
Unresectable stage III non-small cell lung cancer (NSCLC) carries a poor prognosis. The PACIFIC trial established consolidation durvalumab after chemoradiation as a standard treatment; however, its efficacy in patients with driver mutations remains uncertain. This retrospective cohort study analyzed data from three oncology centers in Hong Kong, covering the period from January 2019 to December 2022.
View Article and Find Full Text PDFHepatocellular carcinoma (HCC) represents a significant global health burden, particularly in the Asia-Pacific region, where it is a leading cause of cancer-related mortality. In China alone, HCC accounts for approximately 367,700 new cases and 316,500 deaths annually; over 50% of patients are diagnosed at an advanced stage, limiting curative treatment options and resulting in poor survival outcomes. Systemic therapies combining immune checkpoint inhibitors (ICIs) with antiangiogenic targeted drugs have shown promise in converting unresectable HCC into resectable cases, potentially transforming clinical outcomes.
View Article and Find Full Text PDFJ Thorac Oncol
January 2025
Division of Hematology/Oncology, University of California Irvine School of Medicine, Orange/Irvine, California; Chao Family Comprehensive Cancer Center, Orange/Irvine, California; St. Marianna University School of Medicine, Kawasaki, Japan. Electronic address:
Discov Oncol
January 2025
Hematology Oncology Associates of CNY, Syracuse, USA.
Pancreatic cancer is a highly aggressive malignancy with the majority of patients presenting at a late stage with unresectable or metastatic disease. Even with first line treatment, median survival is approximately 11 months in patients with advanced PDAC. This report details the unique case of a patient that presented with peritoneal metastases from an adenocarcinoma of the body of the pancreas, had a remarkable response to palliative chemotherapy and is alive without evidence of disease 12 months following cessation of all active treatment.
View Article and Find Full Text PDFCancers (Basel)
December 2024
Department of Radiation Oncology, Rutgers Cancer Institute, New Brunswick, NJ 08901, USA.
Unresectable stage III non-small-cell lung cancer (NSCLC) remains a clinical challenge, due to the need for optimal local and systemic control. The management of unresectable Stage III NSCLC has evolved with advancements in radiation therapy (RT), systemic therapies, and immunotherapy. For patients with locally advanced NSCLC who are not surgical candidates, concurrent chemoradiotherapy (CRT) has modest survival outcomes, due to both local progression and distant metastasis.
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