Division of Medical Oncology, The University of Utah Huntsman Cancer Institute, Salt Lake City, UT, USA.
Department of Thoracic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Curr Oncol Rep. 2020 Mar 5;22(4):31. doi: 10.1007/s11912-020-0882-3.
Treatment of locally advanced, unresectable non-small cell lung cancer (NSCLC) has recently been revolutionized by the incorporation of immunotherapy to standard platinum-based concurrent chemoradiation. This review examines the current standard practices and ongoing studies on the management of locally advanced, unresectable NSCLC.
Concurrent chemoradiation is the cornerstone of treatment of unresectable, locally advanced NSCLC. However, chemoradiation can be associated with high therapy-related toxicities, and risk of disease relapse remains significantly elevated despite treatment with curative intent. Durvalumab, a PD-L1 inhibitor, was recently approved as consolidation therapy following concurrent chemoradiation; this agent represents a major advancement in treatment of unresectable stage III NSCLC. Several clinical trials are currently underway to evaluate the benefit of different immunotherapy sequencing and other biomarker-driven strategies in this disease setting. Multiple trials are presently ongoing to assess novel immunotherapy and targeted therapy strategies to improve outcomes and decrease treatment-associated toxicities in patients with locally advanced NSCLC.
免疫疗法联合标准铂类同期放化疗已彻底改变了局部晚期不可切除非小细胞肺癌（NSCLC）的治疗方法。本文综述了局部晚期不可切除 NSCLC 的管理方面的当前标准实践和正在进行的研究。
同期放化疗是不可切除局部晚期 NSCLC 的治疗基石。然而，放化疗可能会引起严重的治疗相关毒性，而且尽管采用了治愈性治疗意图，疾病复发的风险仍然显著升高。PD-L1 抑制剂度伐利尤单抗最近被批准作为同期放化疗后的巩固治疗；该药物的出现代表了不可切除 III 期 NSCLC 治疗的重大进展。目前正在进行多项临床试验，以评估不同免疫治疗方案和其他基于生物标志物的策略在这一疾病治疗中的获益。目前有多项临床试验正在评估新型免疫疗法和靶向治疗策略，以期改善局部晚期 NSCLC 患者的治疗结局并降低治疗相关毒性。
