Out of the darkness and into the light: New strategies for improving treatments for locally advanced non-small cell lung cancer

The standard treatment for locally advanced non-small cell lung cancer (LA NSCLC) includes surgery, radiotherapy, chemotherapy, or some combination of these modalities. Many clinical trials have been conducted in attempts to intensify treatment for LA NSCLC, but with little improvement. A therapeutic plateau had been reached, with no major progress in extending survival for patients with this disease. However, several recent trials of newer targeted therapies and immunotherapies may shed new light on potential therapeutic breakthroughs. The potential benefits from new targeted therapies and immunotherapies in combination with other forms of therapy for LA NSCLC are sufficiently striking as to change current treatment paradigms. Trials of these agents are moving forward from patients with advanced disease to those with earlier stage disease, and from palliative intent to curative intent, which may well revolutionize treatment strategies that have been considered standard over the past several decades. Future studies are needed to explore the role of targeted therapies and immunotherapies in combination with existing therapies for earlier stage disease and for frontline treatment, either as concurrent or perhaps neoadjuvant or adjuvant approaches.