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Follow-Up Imaging Guidelines for Patients with Stage III Unresectable NSCLC: Recommendations Based on the PACIFIC Trial

The PACIFIC trial showed a survival benefit with durvalumab through five years in stage III unresectable non-small cell lung cancer (NSCLC). However, optimal use of imaging to detect disease progression remains unclearly defined for this population. An expert working group convened to consider avail...

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Autores principales: Ko, Jenny J., Banerji, Shantanu, Blais, Normand, Brade, Anthony, Clelland, Cathy, Schellenberg, Devin, Snow, Stephanie, Wheatley-Price, Paul, Yuan, Ren, Melosky, Barbara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10137068/
https://www.ncbi.nlm.nih.gov/pubmed/37185402
http://dx.doi.org/10.3390/curroncol30040289
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author Ko, Jenny J.
Banerji, Shantanu
Blais, Normand
Brade, Anthony
Clelland, Cathy
Schellenberg, Devin
Snow, Stephanie
Wheatley-Price, Paul
Yuan, Ren
Melosky, Barbara
author_facet Ko, Jenny J.
Banerji, Shantanu
Blais, Normand
Brade, Anthony
Clelland, Cathy
Schellenberg, Devin
Snow, Stephanie
Wheatley-Price, Paul
Yuan, Ren
Melosky, Barbara
author_sort Ko, Jenny J.
collection PubMed
description The PACIFIC trial showed a survival benefit with durvalumab through five years in stage III unresectable non-small cell lung cancer (NSCLC). However, optimal use of imaging to detect disease progression remains unclearly defined for this population. An expert working group convened to consider available evidence and clinical experience and develop recommendations for follow-up imaging after concurrent chemotherapy and radiation therapy (CRT). Voting on agreement was conducted anonymously via online survey. Follow-up imaging was recommended for all suitable patients after CRT completion regardless of whether durvalumab is received. Imaging should occur every 3 months in Year 1, at least every 6 months in Year 2, and at least every 12 months in Years 3–5. Contrast computed tomography was preferred; routine brain imaging was not recommended for asymptomatic patients. The medical oncologist should follow-up during Year 1 of durvalumab therapy, with radiation oncologist involvement if pneumonitis is suspected; medical and radiation oncologists can subsequently alternate follow-up. Some patients can transition to the family physician/community primary care team at the end of Year 2. In Years 1–5, patients should receive information regarding smoking cessation, comorbidity management, vaccinations, and general follow-up care. These recommendations provide guidance on follow-up imaging for patients with stage III unresectable NSCLC whether or not they receive durvalumab consolidation therapy.
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spelling pubmed-101370682023-04-28 Follow-Up Imaging Guidelines for Patients with Stage III Unresectable NSCLC: Recommendations Based on the PACIFIC Trial Ko, Jenny J. Banerji, Shantanu Blais, Normand Brade, Anthony Clelland, Cathy Schellenberg, Devin Snow, Stephanie Wheatley-Price, Paul Yuan, Ren Melosky, Barbara Curr Oncol Review The PACIFIC trial showed a survival benefit with durvalumab through five years in stage III unresectable non-small cell lung cancer (NSCLC). However, optimal use of imaging to detect disease progression remains unclearly defined for this population. An expert working group convened to consider available evidence and clinical experience and develop recommendations for follow-up imaging after concurrent chemotherapy and radiation therapy (CRT). Voting on agreement was conducted anonymously via online survey. Follow-up imaging was recommended for all suitable patients after CRT completion regardless of whether durvalumab is received. Imaging should occur every 3 months in Year 1, at least every 6 months in Year 2, and at least every 12 months in Years 3–5. Contrast computed tomography was preferred; routine brain imaging was not recommended for asymptomatic patients. The medical oncologist should follow-up during Year 1 of durvalumab therapy, with radiation oncologist involvement if pneumonitis is suspected; medical and radiation oncologists can subsequently alternate follow-up. Some patients can transition to the family physician/community primary care team at the end of Year 2. In Years 1–5, patients should receive information regarding smoking cessation, comorbidity management, vaccinations, and general follow-up care. These recommendations provide guidance on follow-up imaging for patients with stage III unresectable NSCLC whether or not they receive durvalumab consolidation therapy. MDPI 2023-03-29 /pmc/articles/PMC10137068/ /pubmed/37185402 http://dx.doi.org/10.3390/curroncol30040289 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Ko, Jenny J.
Banerji, Shantanu
Blais, Normand
Brade, Anthony
Clelland, Cathy
Schellenberg, Devin
Snow, Stephanie
Wheatley-Price, Paul
Yuan, Ren
Melosky, Barbara
Follow-Up Imaging Guidelines for Patients with Stage III Unresectable NSCLC: Recommendations Based on the PACIFIC Trial
title Follow-Up Imaging Guidelines for Patients with Stage III Unresectable NSCLC: Recommendations Based on the PACIFIC Trial
title_full Follow-Up Imaging Guidelines for Patients with Stage III Unresectable NSCLC: Recommendations Based on the PACIFIC Trial
title_fullStr Follow-Up Imaging Guidelines for Patients with Stage III Unresectable NSCLC: Recommendations Based on the PACIFIC Trial
title_full_unstemmed Follow-Up Imaging Guidelines for Patients with Stage III Unresectable NSCLC: Recommendations Based on the PACIFIC Trial
title_short Follow-Up Imaging Guidelines for Patients with Stage III Unresectable NSCLC: Recommendations Based on the PACIFIC Trial
title_sort follow-up imaging guidelines for patients with stage iii unresectable nsclc: recommendations based on the pacific trial
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10137068/
https://www.ncbi.nlm.nih.gov/pubmed/37185402
http://dx.doi.org/10.3390/curroncol30040289
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