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How do you manage stage III resectable NSCLC patients treated with neoadjuvant chemoimmunotherapy per CheckMate 816 with residual disease who subsequently refuse surgery?

Would you recommend standard definitive chemoradiation followed by adjuvant durvalumab? Would you treat pre- or post-systemic therapy volumes?
2 Answers
Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · UCLA | VA Greater Los Angeles Healthcare System
Answered on

(1) Carefully analyze what happened with the patient, their medical oncologist, and thoracic surgeon, (2) restage the patient with an FDG-PET/CT and brain MRI to rule out distant metastatic progression, (3) confirm with their medical oncologist that CRT-> Durva is still an option, (4) confirm that a...

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Mednet Member
Mednet Member
Radiation Oncology · Michigan Healthcare Professionals, PC
Answered on

The PACIFIC trial was for unresectable patients, yet extrapolated to many resectable patients (one single station N2 node). If a patient is deemed resectable at tumor board, it’s by definition not eligible for PACIFIC. Thus, they may be treated with chemo-immunotherapy and then undergo surgery, rath...

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