Perspectives on Treatment Advances for Stage III Locally Advanced Unresectable Non-Small-Cell Lung Cancer

For more than a decade, there has been no improvement in outcomes for patients with unresectable locally advanced (LA) non-small-cell lung cancer (NSCLC). The standard treatment in that setting is definitive concurrent chemotherapy and radiation (CCRT). Although the intent of treatment is curative, most patients rapidly progress, and their prognosis is poor, with a 5-year overall survival (OS) rate in the 15%–25% range. Those patients therefore represent a critical unmet need, warranting expedited approval of, and access to, new treatments that can improve outcomes. The PACIFIC trial, which evaluated durvalumab consolidation therapy after CCRT in unresectable LA NSCLC, demonstrated a statistically significant and clinically meaningful improvement in progression-free survival (PFS) and a significant improvement in OS. Durvalumab thus fills a critical unmet need in the setting of unresectable LA NSCLC and provides a new option for patients treated with curative intent. Here, we review the treatment of unresectable LA NSCLC, with a focus on the effect of the clinical data for durvalumab.