Treatment strategies for locally advanced non-small cell lung cancer in elderly patients: Translating scientific evidence into clinical practice. (July 2021)

• Record Type: Journal Article
• Authors: Bonanno, Laura; Attili, Ilaria; Pavan, Alberto; Sepulcri, Matteo; Pasello, Giulia; Rea, Federico; Guarneri, Valentina; Conte, PierFranco
• Is Part Of: Critical reviews in oncology/hematology. Volume 163(2021)
• Publication Date: 2021-07
• Subjects: NSCLC non-small cell lung cancer -- LA-NSCLC locally advanced non-small cell lung cancer -- ECOG Eastern Cooperative Oncology Group -- PS performance status -- CT computed tomography -- PET positron emission tomography -- MRI magnetic resonance imaging -- PD-L1 programmed cell death ligand-1 -- OS overall survival -- PFS progression free survival -- TTDM time to distant metastasis -- HR hazard ratio -- AE adverse event -- irAE immune-related adverse event; Stage III lung cancer -- Elderly -- Radiotherapy -- Chemotherapy -- Immunotherapy -- Concurrent treatment -- Sequential treatment -- Comorbidities; Oncology -- Periodicals; Hematology -- Periodicals; 616.994
• DOI: 10.1016/j.critrevonc.2021.103378
• Languages: English
• ISSNs: 1040-8428

Abstract

Graphical abstract: Highlights: Current standard treatments for locally advanced NSCLC. Focus on treatments for locally advanced NSCLC in elderly patients. Main issues for multimodality approach in elderly patients. Abstract: Treatment of locally advanced NSCLC (LA-NSCLC) is focused on multimodal strategy, including chemotherapy and radiotherapy (in combination or as alternative treatments), followed by surgery in selected cases. Recently, durvalumab consolidation after definitive chemo-radiation has shown a meaningful overall survival benefit. However, it is important to note that elderly patients represent a high proportion of NSCLC population and frailty and comorbidities can significantly limit treatment options. Indeed, elderly patients are under-represented in clinical trials and data to drive treatment selection in this category of patients are scanty. Available data, main issues and controversies on multimodal treatment in elderly LA-NSCLC patients will be reviewed in this paper.