How would you approach adjuvant therapy for a patient with pT2N2 lung adenocarcinoma who underwent an R1 resection and is not amenable to further surgical intervention?

I don't know that I have a trial (much less a randomized one) to prove this, however in this situation, assuming the patient has adequate functional status and has recovered sufficiently from surgery, I would treat the surgery as an extended biopsy. I.e., I would probably (with my radiation colleagues) proceed with definitive chemoRT followed by durvalumab as if a de novo N2 positive stage 3A cancer. NCCN supports either concurrent chemoRT or sequential RT and chemo (for frail) patients who have...