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A Canadian Perspective on the Challenges for Delivery of Curative-Intent Therapy in Stage III Unresectable Non-Small Cell Lung Cancer

1
Department of Radiation Oncology, Peel Regional Cancer Centre, Mississauga, ON L5M 2N1, Canada
2
Department of Hematology and Oncology, Hôpital du Sacré-Coeur de Montréal, Montreal, QC H4J 1C5, Canada
3
Department of Medicine, Burnaby Hospital Cancer Centre, Burnaby, BC V5G 2X6, Canada
4
Department of Medicine, Division of Medical Oncology, University of Toronto, Toronto, ON M5S 3H2, Canada
5
William Osler Health System, Brampton, ON L6R 3J7, Canada
6
Senior Medical Writer, IMPACT Medicom Inc., Toronto, ON M6S 3K2, Canada
7
Department of Radiation Oncology, BC Cancer Agency, Surrey, BC V2V 1Z2, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2021, 28(3), 1618-1629; https://doi.org/10.3390/curroncol28030151
Received: 25 March 2021 / Revised: 19 April 2021 / Accepted: 21 April 2021 / Published: 24 April 2021
(This article belongs to the Section Thoracic Oncology)
Stage III non-small cell lung cancer (NSCLC) comprises a highly heterogenous group of patients with regards to patient fitness and tumour size and distribution, resulting in a wide range of treatment goals and therapy options. Curative-intent multimodality treatment should be considered in all patients with stage III NSCLC. For patients with unresectable disease who are fit, have adequate lung function, and have a disease that can be encompassed within a radical radiation volume, concurrent chemoradiation therapy (cCRT) is the standard of care and can produce cure rates of 20–30%. Recently, consolidation immunotherapy with durvalumab has been recognized as the standard of care following cCRT based on significant improvement rates in overall survival at 4 years. The large heterogeneity of the stage III NSCLC population, along with the need for extensive staging procedures, multidisciplinary care, intensive cCRT, and now consolidation therapy makes the delivery of timely and optimal treatment for these patients complex. Several logistical, communication, and education factors hinder the delivery of guideline-recommended care to patients with stage III unresectable NSCLC. This commentary discusses the potential challenges patients may encounter at different points along their care pathway that can interfere with delivery of curative-intent therapy and suggests strategies for improving care delivery. View Full-Text
Keywords: stage III non-small cell lung cancer; inoperable; curative-intent; chemoradiation therapy; immunotherapy; care pathway stage III non-small cell lung cancer; inoperable; curative-intent; chemoradiation therapy; immunotherapy; care pathway
MDPI and ACS Style

Brade, A.; Jao, K.; Yu, S.; Cheema, P.; Doucette, S.; Christofides, A.; Schellenberg, D. A Canadian Perspective on the Challenges for Delivery of Curative-Intent Therapy in Stage III Unresectable Non-Small Cell Lung Cancer. Curr. Oncol. 2021, 28, 1618-1629. https://doi.org/10.3390/curroncol28030151

AMA Style

Brade A, Jao K, Yu S, Cheema P, Doucette S, Christofides A, Schellenberg D. A Canadian Perspective on the Challenges for Delivery of Curative-Intent Therapy in Stage III Unresectable Non-Small Cell Lung Cancer. Current Oncology. 2021; 28(3):1618-1629. https://doi.org/10.3390/curroncol28030151

Chicago/Turabian Style

Brade, Anthony; Jao, Kevin; Yu, Simon; Cheema, Parneet; Doucette, Sarah; Christofides, Anna; Schellenberg, Devin. 2021. "A Canadian Perspective on the Challenges for Delivery of Curative-Intent Therapy in Stage III Unresectable Non-Small Cell Lung Cancer" Curr. Oncol. 28, no. 3: 1618-1629. https://doi.org/10.3390/curroncol28030151

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