In a patient with both Stage III NSCLC and another concurrent high risk malignancy, how do you sequence consolidation durvalumab with local therapy for the concurrent cancer?  

Lately I have seen patients with a concurrent gynecologic (requiring chemoRT), head and neck (requiring surgery), and early stage NSCLC (requiring SBRT). Often the Stage IIII NSCLC is the most high risk and requires chemoradiation first, but after completing treatment, we are unsure if durvalumab should be delayed to treat the other malignancy or if treatment of the other cancer should be done between IO cycles.



Answer from: Radiation Oncologist at Academic Institution

Answer from: Radiation Oncologist at Community Practice