Multidisciplinary approach for locally advanced non-small cell lung cancer (NSCLC): 2023 expert consensus of the Spanish Lung Cancer Group GECP

• Published in: Clinical & translational oncology Vol. 26; no. 7; pp. 1647 - 1663
• Main Authors: Ospina, Aylen Vanessa, Bolufer Nadal, Sergio, Campo-Cañaveral de la Cruz, José Luis, González Larriba, Jose Luis, Macía Vidueira, Ivan, Massutí Sureda, Bartomeu, Nadal, Ernest, Trancho, Florentino Hernando, Álvarez Kindelán, Antonio, Del Barco Morillo, Edel, Bernabé Caro, Reyes, Bosch Barrera, Joaquim, Calvo de Juan, Virginia, Casal Rubio, Joaquin, de Castro, Javier, Cilleruelo Ramos, Ángel, Cobo Dols, Manuel, Dómine Gómez, Manuel, Figueroa Almánzar, Santiago, Garcia Campelo, Rosario, Insa Mollá, Amelia, Jarabo Sarceda, José Ramón, Jiménez Maestre, Unai, López Castro, Rafael, Majem, Margarita, Martinez-Marti, Alex, Martínez Téllez, Elisabeth, Sánchez Lorente, David, Provencio, Mariano
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 2024
• Subjects: Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - therapy; Consensus; Delphi Technique; Humans; Lung Neoplasms - pathology; Lung Neoplasms - therapy; Medicine; Medicine & Public Health; Neoplasm Staging; Oncology; Patient Care Team; Research Article; Spain; Spain; Neoadjuvant; Locally advanced NSCLC; Surgery; Immunotherapy; Expert consensus
• ISSN: 1699-3055; 1699-048X; 1699-3055
• DOI: 10.1007/s12094-024-03382-y

Introduction
Recent advances in the treatment of locally advanced NSCLC have led to changes in the standard of care for this disease. For the selection of the best approach strategy for each patient, it is necessary the homogenization of diagnostic and therapeutic interventions, as well as the promotion of the evaluation of patients by a multidisciplinary oncology team.
Objective
Development of an expert consensus document with suggestions for the approach and treatment of locally advanced NSCLC leaded by Spanish Lung Cancer Group GECP.
Methods
Between March and July 2023, a panel of 28 experts was formed. Using a mixed technique (Delphi/nominal group) under the guidance of a coordinating group, consensus was reached in 4 phases: 1. Literature review and definition of discussion topics 2. First round of voting 3. Communicating the results and second round of voting 4. Definition of conclusions in nominal group meeting. Responses were consolidated using medians and interquartile ranges. The threshold for agreement was defined as 85% of the votes.
Results
New and controversial situations regarding the diagnosis and management of locally advanced NSCLC were analyzed and reconciled based on evidence and clinical experience. Discussion issues included: molecular diagnosis and biomarkers, radiologic and surgical diagnosis, mediastinal staging, role of the multidisciplinary thoracic committee, neoadjuvant treatment indications, evaluation of response to neoadjuvant treatment, postoperative evaluation, and follow-up.
Conclusions
Consensus clinical suggestions were generated on the most relevant scenarios such as diagnosis, staging and treatment of locally advanced lung cancer, which will serve to support decision-making in daily practice.