Treatment Considerations for Unresectable Locally Advanced NSCLC

May 18, 2018

Treatment Considerations for Unresectable Locally Advanced NSCLC

  • A 64-year-old man presented with shortness of breath and persistent cough of 18 months’ duration; recently, he has experienced chest pain, fatigue, and blood in his sputum. After consulting with his primary care physician, he was referred for oncology evaluation
  • Patient history includes
    • Current smoker (1/2 pack day)
    • Hypertension
    • Acute MI at age 60
  • Evaluation and follow up testing reveal
    • Non-small cell lung cancer in left lung and 2 lymph nodes (Stage IIIa)
    • WHO performance status: 1
    • Histology: adenocarcinoma
    • EFGR, BRAF,andALK/ROS1mutation status: wild-type
    • PD-L1 status: ≥25%
  • He underwent multidisciplinary evaluation and was not a candidate for surgery; he was treated with chemoradiotherapy:
    • Concurrent carboplatin-paclitaxel doublet chemotherapy and radiotherapy (60 Gy)
    • Achieved partial response
  • He had no disease progression 20 days after his last radiotherapy treatment, and began treatment with durvalumab

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