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Real-World Journey of Unresectable Stage III NSCLC Patients: Current Dilemmas for Disease Staging and Treatment

Daily-practice challenges in oncology have been intensified by the approval of immune checkpoint inhibitors (ICI). We aimed to outline current therapy policies and management of locally advanced unresectable stage III non-small-cell lung cancer (NSCLC) in different countries. One thoracic oncologist...

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Autores principales: Agbarya, Abed, Shalata, Walid, Addeo, Alfredo, Charpidou, Andriani, Cuppens, Kristof, Brustugun, Odd Terje, Rajer, Mirjana, Jakopovic, Marco, Marinca, Mihai V., Pluzanski, Adam, Hiltermann, Jeroen, Araújo, António
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949111/
https://www.ncbi.nlm.nih.gov/pubmed/35330063
http://dx.doi.org/10.3390/jcm11061738
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author Agbarya, Abed
Shalata, Walid
Addeo, Alfredo
Charpidou, Andriani
Cuppens, Kristof
Brustugun, Odd Terje
Rajer, Mirjana
Jakopovic, Marco
Marinca, Mihai V.
Pluzanski, Adam
Hiltermann, Jeroen
Araújo, António
author_facet Agbarya, Abed
Shalata, Walid
Addeo, Alfredo
Charpidou, Andriani
Cuppens, Kristof
Brustugun, Odd Terje
Rajer, Mirjana
Jakopovic, Marco
Marinca, Mihai V.
Pluzanski, Adam
Hiltermann, Jeroen
Araújo, António
author_sort Agbarya, Abed
collection PubMed
description Daily-practice challenges in oncology have been intensified by the approval of immune checkpoint inhibitors (ICI). We aimed to outline current therapy policies and management of locally advanced unresectable stage III non-small-cell lung cancer (NSCLC) in different countries. One thoracic oncologist from each of the following countries—Belgium, Croatia, Greece, Israel, the Netherlands, Norway, Poland, Portugal, Romania, Slovenia, and Switzerland—participated in an electronic survey. Descriptive statistics were conducted with categorical variables reported as frequencies and continuous variables as median and interquartile range (IQR) (StataSE-v15). EBUS (endobronchial ultrasound bronchoscopy) was used either upfront or for N2 confirmation. Resectability is still a source of disagreement; thus, decisions vary within each multidisciplinary team. Overall, 66% of stage III patients [IQR 60–75] undergo chemoradiation therapy (CRT); concurrent CRT (cCRT) accounts for most cases (~70%). Performance status is universally used for cCRT eligibility. Induction chemotherapy is fairly weighted based on radiotherapy (RT) availability. Mean time to evaluation after RT completion is less than a month; ICI consolidation is started within six weeks. Durvamulab expenditures are reimbursed in all countries, yet some limiting criteria exist (PD-L1 ≥ 1%, cCRT). No clear guidance on therapies at Durvamulab progression exist; experts agree that it depends on progression timing. Given the high heterogeneity in real-world practices, standardized evidence-based decisions and healthcare provision in NSCLC are needed.
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spelling pubmed-89491112022-03-26 Real-World Journey of Unresectable Stage III NSCLC Patients: Current Dilemmas for Disease Staging and Treatment Agbarya, Abed Shalata, Walid Addeo, Alfredo Charpidou, Andriani Cuppens, Kristof Brustugun, Odd Terje Rajer, Mirjana Jakopovic, Marco Marinca, Mihai V. Pluzanski, Adam Hiltermann, Jeroen Araújo, António J Clin Med Article Daily-practice challenges in oncology have been intensified by the approval of immune checkpoint inhibitors (ICI). We aimed to outline current therapy policies and management of locally advanced unresectable stage III non-small-cell lung cancer (NSCLC) in different countries. One thoracic oncologist from each of the following countries—Belgium, Croatia, Greece, Israel, the Netherlands, Norway, Poland, Portugal, Romania, Slovenia, and Switzerland—participated in an electronic survey. Descriptive statistics were conducted with categorical variables reported as frequencies and continuous variables as median and interquartile range (IQR) (StataSE-v15). EBUS (endobronchial ultrasound bronchoscopy) was used either upfront or for N2 confirmation. Resectability is still a source of disagreement; thus, decisions vary within each multidisciplinary team. Overall, 66% of stage III patients [IQR 60–75] undergo chemoradiation therapy (CRT); concurrent CRT (cCRT) accounts for most cases (~70%). Performance status is universally used for cCRT eligibility. Induction chemotherapy is fairly weighted based on radiotherapy (RT) availability. Mean time to evaluation after RT completion is less than a month; ICI consolidation is started within six weeks. Durvamulab expenditures are reimbursed in all countries, yet some limiting criteria exist (PD-L1 ≥ 1%, cCRT). No clear guidance on therapies at Durvamulab progression exist; experts agree that it depends on progression timing. Given the high heterogeneity in real-world practices, standardized evidence-based decisions and healthcare provision in NSCLC are needed. MDPI 2022-03-21 /pmc/articles/PMC8949111/ /pubmed/35330063 http://dx.doi.org/10.3390/jcm11061738 Text en © 2022 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 Article
Agbarya, Abed
Shalata, Walid
Addeo, Alfredo
Charpidou, Andriani
Cuppens, Kristof
Brustugun, Odd Terje
Rajer, Mirjana
Jakopovic, Marco
Marinca, Mihai V.
Pluzanski, Adam
Hiltermann, Jeroen
Araújo, António
Real-World Journey of Unresectable Stage III NSCLC Patients: Current Dilemmas for Disease Staging and Treatment
title Real-World Journey of Unresectable Stage III NSCLC Patients: Current Dilemmas for Disease Staging and Treatment
title_full Real-World Journey of Unresectable Stage III NSCLC Patients: Current Dilemmas for Disease Staging and Treatment
title_fullStr Real-World Journey of Unresectable Stage III NSCLC Patients: Current Dilemmas for Disease Staging and Treatment
title_full_unstemmed Real-World Journey of Unresectable Stage III NSCLC Patients: Current Dilemmas for Disease Staging and Treatment
title_short Real-World Journey of Unresectable Stage III NSCLC Patients: Current Dilemmas for Disease Staging and Treatment
title_sort real-world journey of unresectable stage iii nsclc patients: current dilemmas for disease staging and treatment
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949111/
https://www.ncbi.nlm.nih.gov/pubmed/35330063
http://dx.doi.org/10.3390/jcm11061738
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