Place de l'immunothérapie dans les CBNPC de stade III non résécables

Abstract

Treatment of unresectable stage III non-small cell lung cancer is currently based on a combination of chemotherapy and radiotherapy, ideally concurrent, followed by consolidation with durvalumab administered for 1 year. Although this new therapeutic standard illustrates the technical progress of thoracic irradiation and the positive impact of anti-PD-L1 in the context of locally advanced disease, the results (progression-free survival of 34% at 5 years and overall survival of 43% at 5 years, no survival benefit in the absence of PD-L1 expression or in case of EGFR mutation) underline the need for further therapeutic improvement. This could involve optimizing strategies for combining immunotherapy with chemoradiotherapy, redefining the parameters of thoracic radiotherapy to promote synergy with immunotherapy, and integrating targeted therapies into the therapeutic strategy in cases of oncogenic addiction.