Asian Thoracic Oncology Research Group Expert Consensus Statement on Optimal Management of Stage III NSCLC
Journal
Journal of Thoracic Oncology
Journal Volume
15
Journal Issue
3
Pages
324-343
Date Issued
2020
Author(s)
Tan W.L.
Chua K.L.M.
Lee V.H.F.
Tho L.M.
Chan A.W.
Ho G.F.
Reungwetwattana T.
Kim D.-W.
Soo R.A.
Ahn Y.C.
Onishi H.
Ahn M.-J.
Mok T.S.K.
Tan D.S.W.
Yang F.
Abstract
Stage III NSCLC represents a heterogeneous disease for which optimal treatment continues to pose a clinical challenge. Recent changes in the American Joint Commission on Cancer staging to the eighth edition has led to a shift in TNM stage grouping and redefined the subcategories (IIIA–C) in stage III NSCLC for better prognostication. Although concurrent chemoradiotherapy has remained standard-of-care for stage III NSCLC for almost 2 decades, contemporary considerations include the impact of different molecular subsets of NSCLC, and the roles of tyrosine kinase inhibitors post-definitive therapy and of immune checkpoint inhibitors following chemoradiotherapy. With rapid evolution of diagnostic algorithms and expanding treatment options, the need for interdisciplinary input involving multiple specialists (medical oncologists, radiation oncologists, pulmonologists, radiologists, pathologists and thoracic surgeons) has become increasingly important. The unique demographics of Asian NSCLC pose further challenges when applying clinical trial data into clinical practice. This includes differences in smoking rates, prevalence of oncogenic driver mutations, and access to health care resources including molecular testing, prompting the need for critical review of existing data and identification of current gaps. In this expert consensus statement by the Asian Thoracic Oncology Research Group, an interdisciplinary group of experts representing Hong Kong, Korea, Japan, Taiwan, Singapore, Thailand, Malaysia, and Mainland China was convened. Standard clinical practices for stage III NSCLC across different Asian countries were discussed from initial diagnosis and staging through to multi-modality approaches including surgery, chemotherapy, radiation, targeted therapies, and immunotherapy. ? 2019
Other Subjects
cisplatin; durvalumab; erlotinib; etoposide; gefitinib; gemcitabine; icotinib; pemetrexed; platinum derivative; vinblastine; cancer immunotherapy; cancer radiotherapy; cancer staging; cancer surgery; chemoradiotherapy; China; consensus; health care organization; Hong Kong; human; Japan; Korea; lobectomy; lung surgery; Malaysia; medical expert; neoadjuvant chemotherapy; non small cell lung cancer; nonhuman; patient care; pneumonia; prevalence; priority journal; Review; Singapore; skull irradiation; Taiwan; Thailand; cancer staging; consensus; lung tumor; pathology; South Korea; China; Consensus; Hong Kong; Humans; Japan; Lung Neoplasms; Neoplasm Staging; Republic of Korea; Taiwan
Publisher
Elsevier Inc
Type
review