Swinging for the Fences in the Curative Setting for NSCLC

Over the past 20 years, we have witnessed a remarkable transformation for patients with advanced lung cancer, thanks in large part to progress in molecular oncology and immunotherapy.

Now, as we turn the page on another year, it's customary to offer some predictions moving forward.

I predict that over the next few years we will see similar positive trials in early-stage non–small cell lung cancer (NSCLC) and competing treatment alternatives emerge, as we have seen in the stage IV setting.

For example, in 15 years, treatment for advanced NSCLC has gone from the same platinum doublet chemotherapy regimen for everyone to an array of immunotherapy and chemotherapy combinations based on PD-L1 expression and other features of a patient's cancer. And overall survival has gone from being measured in months to years for many more patients.

A growing body of recent evidence supports a similar transformation in earlier-stage disease, where the stakes are higher and cure may be possible. Already in the past few years, promising data have emerged and led to new FDA approvals in potentially curative settings.

For instance, we found that adding consolidation durvalumab after chemoradiation in patients with stage III unresectable NSCLC resulted in highly significant improvements in disease-free survival