Concurrent chemoradiotherapy (cCRT) followed by one year of consolidation durvalumab is the current standard-of-care for patients with unresectable stage III non-small cell lung cancer (NSCLC), of good functional status. However, cCRT and consolidation durvalumab may be challenging to administer for selected patient populations underrepresented or even excluded in clinical trials: older and/or frail patients; those with cardiovascular or respiratory comorbidities in which treatment-related adverse events may be higher, and patients with pre-existing autoimmune disorders for whom immunotherapy use is controversial. In this narrative review, we discuss the current evidence, challenges, ongoing clinical trials and potential future treatment scenarios in relevant subgroups of patients with locally advanced NSCLC, who are underrepresented in clinical trials.
Keyphrases
- clinical trial
- locally advanced
- end stage renal disease
- rectal cancer
- small cell lung cancer
- ejection fraction
- newly diagnosed
- chronic kidney disease
- squamous cell carcinoma
- healthcare
- neoadjuvant chemotherapy
- prognostic factors
- radiation therapy
- multiple sclerosis
- palliative care
- climate change
- randomized controlled trial
- lymph node
- case report
- risk assessment
- quality improvement
- combination therapy
- study protocol
- drug induced