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Immunotherapy Arrives in Stage III NSCLC, But Questions Remain

Kristi Rosa
Published: Monday, Nov 26, 2018

Thomas A. Hensing, MD

Thomas A. Hensing, MD
Although an optimal treatment approach has yet to be identified for patients with stage III non–small cell lung cancer (NSCLC), Thomas Hensing, MD, explained that significant progress has been made with the introduction of immunotherapy agents to the field.

on Advanced Non–Small Cell Lung Cancer, Hensing discussed the emergence of immunotherapy in the stage III NSCLC armamentarium, and questions that must be answered to build on this initial success.

OncLive: What are the currently available treatment options for patients with stage IIIa NSCLC?

Hensing: For most patients who come in with stage III disease—a disease that’s locally advanced within the chest—we treat it with a combination of modalities. Most patients will likely be treated with some kind of chemotherapy and radiation. The biggest new addition to that is now—at least for some patients—immune checkpoint inhibitors that have recently been shown to significantly improve OS.

What trials have evaluated the use of immune checkpoint inhibitors in this population?

A significant landmark study that was just published was the PACIFIC trial. In that study, they randomized patients who came in with stage III disease that was not operable; these patients had received chemotherapy and radiation and were randomized to 1 year of durvalumab versus placebo. What they showed last year was that the progression free survival (PFS) rate in patients improved significantly by more than 11 months.
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