Recent advances in the management of Stage III lung cancer

Stage III lung cancer is a heterogenous disease, and is divided into Stage III A and Stage III B. While Stage III A comprises T4 N 0–1, T 3 N1 and T 1–3 N2, Stage III B comprises of T 1–3 N 3 whose mediastinal nodes are positive on CT scan. Stage III A disease is usually amenable to surgical resection followed by chemotherapy + radiation, either concurrently, or sequentially, whereas Stage III B is usually treated like Stage IV with systemic therapy. Any Stage III lung cancer should be evaluated pretreatment by multidisciplinary evaluation including thoracic surgeons, medical oncologists and radiation oncologists, because Stage III lung cancer is amenable to multimodality treatment, and a single modality usually does not suffice. Most of the recent advances in the treatment of Stage III lung cancer have been in systemic therapy, namely chemotherapy and targeted therapy.