Early and locally advanced non-small-cell lung cancer: an update of the ESMO Clinical Practice Guidelines focusing on diagnosis, staging, systemic and local therapy

Abstract

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Model Calibration of Pharmacokinetic-Pharmacodynamic Lung Tumour Dynamics for Anticancer Therapies

“…Decisions about the recommended radiotherapy regimen were based on a multidisciplinary discussion to provide consensus for SBRT applicability, safety, and risks, in order to better assist management care and individualized treatment. For SBRT simulation, planning, and delivery, commonly used prescription doses and normal tissue dose constraints were taken into consideration by the medical team from GZA hospital, based on published experience and current guidelines [36][37][38][39][40], ongoing trials, historical data, modeling, and empirical judgment. Treatment planning was performed using a TrueBeam linear accelerator (Varian Medical Systems) and dose calculations were carried out with a colapsed cone convolution algorithm (RayStation TPS, RaySearch Laboratories) characterised by a set of user-definable configuration parameters [41,42].…”

“…The treatment planning uses prior knowledge highlighted in clinical practice recommendations for stereotactic treatments [36][37][38][39][40]43,44]. The dose and fractionation regimens, as presented in Table 2, are patient-specific and limited by a subset of historically used maximum dose constraints.…”

Role of Adjuvant Radiotherapy in Non-Small Cell Lung Cancer—A Review

“…The benefits of chemotherapy in patients with completely resected NSCLC have been demonstrated in many phase 3 studies and a meta-analysis, with an absolute survival benefit of 5% at 5 years [ 10 ]. Neoadjuvant or adjuvant chemotherapy is recommended for patients with stage IIB to IIIA and can be considered for patients with stage IIA with a resected primary tumor of >4 cm [ 1 , 2 , 11 ]. Nodal positive patients have a significant risk of locoregional recurrence even after R0 resection and neoadjuvant or adjuvant chemotherapy [ 9 , 12 ].…”

“…Likewise, in the same setting, adjuvant ICIs with anti-PD-L1 agents (e.g., atezolizumab or pembrolizumab) lead to increased disease-free survival (DFS) versus best supportive care for patients with PD-L1-positive tumors (IMpower010 [ 14 ], PEARLS [ 15 ]). The role of (neo)adjuvant immunotherapy in stage IB–IIIA NSCLC is rapidly developing and several large randomized phase 3 clinical trials are underway [ 11 , 13 , 15 ]. Osimertinib is indicated for the adjuvant treatment after complete resection with stage IB–IIIA EGFR-mutated NSCLC patients [ 11 , 16 ].…”

Chaperone-Mediated Autophagy Markers LAMP2A and HSPA8 in Advanced Non-Small Cell Lung Cancer after Neoadjuvant Therapy

“…Patients also profit from immunotherapy and immune checkpoint inhibitors, which have recently been approved for unresectable stage III cancer therapy [5,6]. Even with the unquestionable progress in treatments, the overall survival remains poor [7] and novel therapies, especially for patients with advanced cancers, are in high demand.…”