The Society of Thoracic Surgeons Expert Consensus on the Multidisciplinary Management and Resectability of Locally Advanced Non-small Cell Lung Cancer.

Background: The contemporary management and resectability of locally advanced lung cancer are undergoing significant changes as new data emerge regarding immunotherapy and targeted treatments. The objective of this document is to review the literature and present consensus among a group of multidisciplinary experts to guide the determination of resectability and management of locally advanced non-small cell lung cancer (NSCLC) in the context of contemporary evidence.
Methods: The Society of Thoracic Surgeon Workforce on Thoracic Surgery assembled a multidisciplinary expert panel composed of thoracic surgeons and medical and radiation oncologists with established expertise in the management of lung cancer. A focused literature review was performed, and expert consensus statements were developed using a modified Delphi process to address 3 major themes: (1) assessing resectability and multidisciplinary management of locally advanced lung cancer, (2) neoadjuvant (including perioperative) therapy, and (3) adjuvant therapy.
Results: A consensus was reached on 19 recommendations. These consensus statements reflect updated insights on resectability and multidisciplinary management of locally advanced lung cancer based on the latest literature and current clinical experience, mainly focusing on the appropriateness of surgical therapy and emerging data regarding neoadjuvant and adjuvant therapies.
Conclusions: Despite the complex decision-making process in managing locally advanced lung cancer, this expert panel agreed on several key recommendations. This document provides guidance for thoracic surgeons and other medical professionals in the optimal management of locally advanced lung cancer based on the most updated evidence and literature.
Competing Interests: Disclosures Samuel S. Kim reports a relationship with Intuitive Surgical Inc that includes: funding grants and speaking and lecture fees. David T. Cooke reports a relationship with Bristol-Myers Squibb Co that includes: speaking and lecture fees. Biniam Kidane reports a relationship with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory and speaking and lecture fees; with Merck & Co Inc that includes: consulting or advisory and speaking and lecture fees; with Roche that includes: consulting or advisory and speaking and lecture fees; with Medtronic that includes: consulting or advisory and speaking and lecture fees; and with Olympus Corporation that includes: consulting or advisory and speaking and lecture fees. Samuel S. Kim reports a relationship with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory. Luis Tapia Vargas reports a relationship with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory. Jyoti Patel reports a relationship with AbbVie Inc that includes: consulting or advisory; with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory; with Bristol-Myers Squibb Co that includes: consulting or advisory; with Gilead Sciences Inc that includes: consulting or advisory; with Guardant Health Inc that includes: consulting or advisory; with Sanofi that includes: consulting or advisory; with Tempus that includes: consulting or advisory; with AnHeart Therapeutics that includes: consulting or advisory; with Blueprint Genetics that includes: consulting or advisory; and with Black Diamond Therapeutics that includes: consulting or advisory. Joel Neal reports a relationship with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory; with Genetec Inc that includes: consulting or advisory; with Exelixis Inc that includes: consulting or advisory; with Takeda Pharmaceutical Company Ltd that includes: consulting or advisory; with Eli Lilly and Company that includes: consulting or advisory; with Amgen Inc that includes: consulting or advisory; with Sanofi that includes: consulting or advisory; and with Bristol-Myers Squibb Co that includes: consulting or advisory. Joseph Shrager reports a relationship with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory and with Becton Dickinson and Company that includes: consulting or advisory. The other authors have no conflicts of interest to disclose.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)