Next Article in Journal
Organoid Models for Cancer Research—From Bed to Bench Side and Back
Next Article in Special Issue
Endobronchial Ultrasonography with a Guide Sheath Transbronchial Biopsy for Diagnosing Peripheral Pulmonary Lesions within or near Fibrotic Lesions in Patients with Interstitial Lung Disease
Previous Article in Journal
Targeted Sequencing Revealed Distinct Mutational Profiles of Ocular and Extraocular Sebaceous Carcinomas
Previous Article in Special Issue
Adjuvant Treatment with Tyrosine Kinase Inhibitors in Epidermal Growth Factor Receptor Mutated Non-Small-Cell Lung Carcinoma Patients, Past, Present and Future
Review

Management of Resectable Stage III-N2 Non-Small-Cell Lung Cancer (NSCLC) in the Age of Immunotherapy

1
Department of Medical Oncology, Hospital Universitario Fundación Alcorcón, 28922 Madrid, Spain
2
Department of Radiation Oncology, Hospital Universitario Fuenlabrada, 28942 Madrid, Spain
3
Department of Thoracic Surgery, Hospital Universitario Cruces, 48903 Barakaldo, Bizkaia, Spain
4
Department of Radiation Oncology, Fundación Jiménez Díaz, 28040 Madrid, Spain
5
Department of Medical Oncology, Hospital Universitari Clínic Barcelona, 08036 Barcelona, Spain
6
Department of Radiation Oncology, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
7
Department of Radiation Oncology, Hospital Universitario Quirónsalud Madrid, 28223 Madrid, Spain
8
Department of Radiation Oncology, Hospital La Luz, 28003 Madrid, Spain
9
Medicine Department, School of Biomedical Siciences, Universidad Europea, 28670 Madrid, Spain
*
Author to whom correspondence should be addressed.
Academic Editor: Francesco Petrella
Cancers 2021, 13(19), 4811; https://doi.org/10.3390/cancers13194811
Received: 20 August 2021 / Revised: 21 September 2021 / Accepted: 22 September 2021 / Published: 26 September 2021
(This article belongs to the Special Issue Diagnosis and Treatment of Primary and Secondary Lung Cancers)
The treatment of resectable stage III non-small-cell lung cancer with N2 lymph node involvement is usually multimodal and is generally based on neoadjuvant chemotherapy +/− radiotherapy followed by surgery, but the cure rate is still low. Immunotherapy based on anti-PD1/PD-L1 immune checkpoint inhibitors has improved survival in advanced and stage III non-resectable NSCLC patients and is being studied in earlier stages to improve the cure rate of lung cancer. In this article, we review all therapeutic approaches to stage III-N2 NSCLC, analysing both completed and ongoing studies that evaluate the addition of immunotherapy with or without chemotherapy and/or radiotherapy.
Stage III non-small-cell lung cancer (NSCLC) with N2 lymph node involvement is a heterogeneous group with different potential therapeutic approaches. Patients with potentially resectable III-N2 NSCLC are those who are considered to be able to receive a multimodality treatment that includes tumour resection after neoadjuvant therapy. Current treatment for these patients is based on neoadjuvant chemotherapy +/− radiotherapy followed by surgery and subsequent assessment for adjuvant chemotherapy and/or radiotherapy. In addition, some selected III-N2 patients could receive upfront surgery or pathologic N2 incidental involvement can be found a posteriori during analysis of the surgical specimen. The standard treatment for these patients is adjuvant chemotherapy and evaluation for complementary radiotherapy. Despite being a locally advanced stage, the cure rate for these patients continues to be low, with a broad improvement margin. The most immediate hope for improving survival data and curing these patients relies on integrating immunotherapy into perioperative treatment. Immunotherapy based on anti-PD1/PD-L1 immune checkpoint inhibitors is already a standard treatment in stage III unresectable and advanced NSCLC. Data from the first phase II studies in monotherapy neoadjuvant therapy and, in particular, in combination with chemotherapy, are highly promising, with impressive improved and complete pathological response rates. Despite the lack of confirmatory data from phase III trials and long-term survival data, and in spite of various unresolved questions, immunotherapy will soon be incorporated into the armamentarium for treating stage III-N2 NSCLC. In this article, we review all therapeutic approaches to stage III-N2 NSCLC, analysing both completed and ongoing studies that evaluate the addition of immunotherapy with or without chemotherapy and/or radiotherapy. View Full-Text
Keywords: non-small-cell lung cancer; NSCLC; N2; resectable; immunotherapy; stage III; perioperative non-small-cell lung cancer; NSCLC; N2; resectable; immunotherapy; stage III; perioperative
MDPI and ACS Style

Mielgo-Rubio, X.; Montemuiño, S.; Jiménez, U.; Luna, J.; Cardeña, A.; Mezquita, L.; Martín, M.; Couñago, F. Management of Resectable Stage III-N2 Non-Small-Cell Lung Cancer (NSCLC) in the Age of Immunotherapy. Cancers 2021, 13, 4811. https://doi.org/10.3390/cancers13194811

AMA Style

Mielgo-Rubio X, Montemuiño S, Jiménez U, Luna J, Cardeña A, Mezquita L, Martín M, Couñago F. Management of Resectable Stage III-N2 Non-Small-Cell Lung Cancer (NSCLC) in the Age of Immunotherapy. Cancers. 2021; 13(19):4811. https://doi.org/10.3390/cancers13194811

Chicago/Turabian Style

Mielgo-Rubio, Xabier, Sara Montemuiño, Unai Jiménez, Javier Luna, Ana Cardeña, Laura Mezquita, Margarita Martín, and Felipe Couñago. 2021. "Management of Resectable Stage III-N2 Non-Small-Cell Lung Cancer (NSCLC) in the Age of Immunotherapy" Cancers 13, no. 19: 4811. https://doi.org/10.3390/cancers13194811

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop