For patients with potentially resectable stage III superior sulcus NSCLC, do you incorporate immunotherapy in your multi-modality treatment after chemoradiation?

Topics: Radiation Oncology • Thoracic Malignancies • Medical Oncology • SWOG

Answer from: Medical Oncologist at Academic Institution

There is no evidence to support this. I would say that durvalumab has demonstrated a clear survival benefit after chemo/radiation in patients who have unresectable disease, and it has not been studied in patients with resectable NSCLC. If you want to extrapolate to give it as adjuvant therapy...

Comments

Medical Oncologist at Baptist Cancer Center
Completely agree. All such patients should be enro...

Medical Oncologist at Cancer Care Specialists/Renown Oncology/UNR
For resectable pancoast tumor, is radiation really...

Medical Oncologist at Baptist Cancer Center
These are great questions! I can address them. ...

Medical Oncologist at Cancer Care Specialists/Renown Oncology/UNR
Great answers, thanks a lot!

Answer from: Medical Oncologist at Community Practice

No. Durvalumab therapy in NSCLC is currently limited to patients with unresectable disease. PACIFIC clearly demonstrated an enduring survival benefit of consolidative Durvalumab therapy after combined chemo-radiation therapy in patients who did not undergo surgical resection. The NeoCOAST trial is c...

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Medical Oncologist at Cancer Care Specialists/Renown Oncology/UNR
Will INCREASE trial data change your practice?

Answer from: Medical Oncologist at Community Practice

Based on the data and NCCN guidelines, yes for immunotherapy (atezolizumab) and no for durvalumab. For superior sulcus tumors with T3 invasion and N0-1 nodal involvement, preoperative concurrent chemoradiation followed by surgery plus adjuvant chemotherapy and atezolizumab or osimertinib (dep...

Comments

Medical Oncologist at Baptist Cancer Center
Appreciate that we often have to extrapolate to co...

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