How do you approach patients with stage III unresectable, combined histology NSCLC/SCLC?

For stage III lung cancer with mixed NSCLC and small-cell lung cancer, we treat patients with concurrent chemotherapy (cisplatin/etoposide every three weeks) and definitive radiotherapy (60-66 Gy in 30 fractions, QD), followed by adjuvant immunotherapy (durvalumab). The rationales are as follows:

1. Radiotherapy at 60-66 Gy in 30 fractions QD is the standard of care for NSCLC and an accepted alternative regimen for small-cell lung cancer (CONVERT Trial).
2. Cisplatin/etoposide is the standard chemothe...

This is a difficult question and I am not sure there is a "right answer". I would probably discuss with my pathologist what seems to be the more dominant histology if there is one. I would choose cisplatin with etoposide rather than carboplatin with paclitaxel as the chemotherapy backbone due to the small cell histology if the patient qualifies for that combination. I would weigh the risks and the benefits and have a detailed discussion with the patient about the uncertainties. The same question...