For locally recurrent NSCLC after surgical resection but with subcentimeter ipsilateral nodules of indeterminate etiology, would you consider local therapy such as chemoradiation +/- durvalumab?

Time to relapse influences the treatment modality. Presuming relapse occurs at least a year or more after the initial surgery, we typically triage and re-evaluate if surgical resection is feasible again for local recurrence after prior resection. Since these are subcentimeter and of indeterminate etiology, we confirm histology with percutaneous biopsy typically first before treatment planning. If not amenable to biopsy but clearly growing and no other etiology identified, surgery such as wedge resection (or completion pneumonectomy as indicated) both as diagnostic and therapeutic approach may be performed in the patient if a candidate for such procedure.

If proven to be malignant and not a candidate for surgery or the patient prefers non-su...