Kim Floryane, Borgeaud Maxime, Addeo Alfredo, Friedlaender Alex
Oncology Department, Geneva University Hospitals, 1205 Geneva, Switzerland.
Oncology Department, Clinique Générale Beaulieu, 1206 Geneva, Switzerland.
Explor Target Antitumor Ther. 2024;5(1):85-95. doi: 10.37349/etat.2024.00206. Epub 2024 Feb 19.
Lung cancer remains the most common cause of cancer death across the world. Non-small-cell lung cancer (NSCLC) represents the most frequent type of lung cancer and is frequently diagnosed at an advanced stage. Stage III NSCLC, which encompasses 30% of cases, refers to a state between localized and metastatic disease, and is associated with poor prognosis. As highlighted in this review, stage III represents a heterogenous group, whose complex management includes multimodal treatment, discussed below, and requires discussion in multidisciplinary teams. The goal of this approach is a maximalist attitude in these patients with locally advanced and non-metastatic disease. However, many issues remain under debate including the optimal sequences of treatment between different treatment modalities, patient selection particularly for surgery, the duration of perioperative treatments and the identification of biomarkers to determine which patients might benefit of specific treatment like immunotherapy and targeted therapies. This review describes the current landscape of management of stage III NSCLC, discussing the critical issue of resectability, and highlighting the recent advancements in the field, particularly the incorporation of immune-checkpoint inhibitors (ICIs) and targeted therapies in this setting.
肺癌仍然是全球癌症死亡的最常见原因。非小细胞肺癌（NSCLC）是最常见的肺癌类型，且常被诊断为晚期。Ⅲ期NSCLC占病例的30%，指的是介于局限性疾病和转移性疾病之间的状态，预后较差。正如本综述所强调的，Ⅲ期代表一个异质性群体，其复杂的管理包括下文讨论的多模式治疗，并且需要在多学科团队中进行讨论。这种方法的目标是对这些局部晚期且无转移疾病的患者采取积极的态度。然而，许多问题仍在争论中，包括不同治疗方式之间的最佳治疗顺序、特别是手术患者的选择、围手术期治疗的持续时间以及生物标志物的识别，以确定哪些患者可能从免疫疗法和靶向疗法等特定治疗中获益。本综述描述了Ⅲ期NSCLC的当前管理现状，讨论了可切除性的关键问题，并强调了该领域的最新进展，特别是免疫检查点抑制剂（ICI）和靶向疗法在这种情况下的应用。
