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Asian Thoracic Oncology Research Group expert consensus statement on optimal management of stage III non-small cell lung cancer.

Abstract

Stage III non-small cell lung cancer (NSCLC) represents a heterogeneous disease for which optimal treatment continues to pose a clinical challenge. Recent changes in the American Joint Commission on Cancer (AJCC) staging to the 8th edition has led to a shift in TNM stage grouping and redefined the subcategories (IIIA-C) in stage III NSCLC for better prognostication. Although concurrent chemoradiotherapy (CCRT) has remained standard of care for Stage III NSCLC for almost 2 decades, contemporary considerations include the impact of different molecular subsets of NSCLC, role of tyrosine kinase inhibitors (TKIs) post-definitive therapy, and of immune checkpoint inhibitors following chemoradiotherapy. With rapid evolution of diagnostic algorithms and expanding treatment options, the need for interdisciplinary input - involving multiple specialists (medical oncologists, pulmonologists, radiologists and thoracic surgeons) has become increasingly important. The unique demographics of Asian NSCLC pose further challenges when applying clinical trial data into clinical practice. This includes differences in smoking rates, prevalence of oncogenic driver mutations, and access to healthcare resources including molecular testing, prompting the need for critical review of existing data and identification of current gaps. In this expert consensus statement by the Asian Thoracic Oncology Research Group (ATORG), an interdisciplinary group of experts representing Hong Kong, Korea, Japan, Taiwan, Singapore, Thailand, Malaysia and Mainland China was convened. Standard clinical practices for stage III NSCLC across different Asian countries were discussed from initial diagnosis, staging through to multi-modality approaches including surgery, chemotherapy, radiation, targeted therapies and immunotherapy.

Authors+Show Affiliations

Division of Medical Oncology, National Cancer Centre Singapore.Division of Radiation Oncology, National Cancer Centre Singapore.Department of Oncology, National Taiwan University Hospital.Department of Clinical Oncology, The University of Hong Kong.Clinical Oncology, Beacon Hospital, Petaling Jaya, Malaysia.Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong.Department of Clinical Oncology, University Malaya Medical Centre.Department of Internal Medicine, Division of Medical Oncology, Ramathibodi Hospital, Mahidol University.Department of Oncology, National Taiwan University Hospital.Department of Internal Medicine, Seoul National University Hospital.Department of Hematology Oncology, National University Hospital, Singapore.Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine.Department of Radiology, University of Yamanashi.Department of Internal Medicine, Division of Medical Oncology, Samsung Medical Center, Sungkyunkwan, University School of Medicine.Department of Clinical Oncology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong.Division of Medical Oncology, National Cancer Centre Singapore. Electronic address: daniel.tan.s.w@singhealth.com.sg.Department of Thoracic Surgery, Peking University People's Hospital.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31733357

Citation

Tan, Wan Ling, et al. "Asian Thoracic Oncology Research Group Expert Consensus Statement On Optimal Management of Stage III Non-small Cell Lung Cancer." Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer, 2019.
Tan WL, Chua KLM, Lin CC, et al. Asian Thoracic Oncology Research Group expert consensus statement on optimal management of stage III non-small cell lung cancer. J Thorac Oncol. 2019.
Tan, W. L., Chua, K. L. M., Lin, C. C., Lee, V. H. F., Tho, L. M., Chan, A. W., ... Yang, F. (2019). Asian Thoracic Oncology Research Group expert consensus statement on optimal management of stage III non-small cell lung cancer. Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer, doi:10.1016/j.jtho.2019.10.022.
Tan WL, et al. Asian Thoracic Oncology Research Group Expert Consensus Statement On Optimal Management of Stage III Non-small Cell Lung Cancer. J Thorac Oncol. 2019 Nov 13; PubMed PMID: 31733357.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Asian Thoracic Oncology Research Group expert consensus statement on optimal management of stage III non-small cell lung cancer. AU - Tan,Wan Ling, AU - Chua,Kevin L M, AU - Lin,Chia-Chi, AU - Lee,Victor H F, AU - Tho,Lye Mun, AU - Chan,Anthony W, AU - Ho,Gwo Fuang, AU - Reungwetwattana,Thanyanan, AU - Yang,James C, AU - Kim,Dong-Wan, AU - Soo,Ross A, AU - Chan Ahn,Yong, AU - Onishi,Hiroshi, AU - Ahn,Myung-Ju, AU - Mok,Tony S K, AU - Tan,Daniel S W, AU - Yang,Fan, Y1 - 2019/11/13/ PY - 2019/08/05/received PY - 2019/10/24/revised PY - 2019/10/24/accepted PY - 2019/11/17/entrez PY - 2019/11/17/pubmed PY - 2019/11/17/medline KW - Asian KW - Consensus statement KW - stage III NSCLC JF - Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer JO - J Thorac Oncol N2 - Stage III non-small cell lung cancer (NSCLC) represents a heterogeneous disease for which optimal treatment continues to pose a clinical challenge. Recent changes in the American Joint Commission on Cancer (AJCC) staging to the 8th edition has led to a shift in TNM stage grouping and redefined the subcategories (IIIA-C) in stage III NSCLC for better prognostication. Although concurrent chemoradiotherapy (CCRT) has remained standard of care for Stage III NSCLC for almost 2 decades, contemporary considerations include the impact of different molecular subsets of NSCLC, role of tyrosine kinase inhibitors (TKIs) post-definitive therapy, and of immune checkpoint inhibitors following chemoradiotherapy. With rapid evolution of diagnostic algorithms and expanding treatment options, the need for interdisciplinary input - involving multiple specialists (medical oncologists, pulmonologists, radiologists and thoracic surgeons) has become increasingly important. The unique demographics of Asian NSCLC pose further challenges when applying clinical trial data into clinical practice. This includes differences in smoking rates, prevalence of oncogenic driver mutations, and access to healthcare resources including molecular testing, prompting the need for critical review of existing data and identification of current gaps. In this expert consensus statement by the Asian Thoracic Oncology Research Group (ATORG), an interdisciplinary group of experts representing Hong Kong, Korea, Japan, Taiwan, Singapore, Thailand, Malaysia and Mainland China was convened. Standard clinical practices for stage III NSCLC across different Asian countries were discussed from initial diagnosis, staging through to multi-modality approaches including surgery, chemotherapy, radiation, targeted therapies and immunotherapy. SN - 1556-1380 UR - https://www.unboundmedicine.com/medline/citation/31733357/Asian_Thoracic_Oncology_Research_Group_expert_consensus_statement_on_optimal_management_of_stage_III_non-small_cell_lung_cancer L2 - https://linkinghub.elsevier.com/retrieve/pii/S1556-0864(19)33640-8 DB - PRIME DP - Unbound Medicine ER -