Stage III non-small cell lung cancer: escalation matters, but how?

Concurrent chemoradiation (CRT) as the standard treatment for unresectable stage III non-small cell lung cancer (NSCLC) has reached a therapeutic plateau. Variations in the chemotherapy backbone and addition of consolidation chemotherapy have failed to improve survival (1). Attempts to escalate radiation dose have been met with failure as well (2). As a result, the 5-year overall survival of locally advanced NSCLC has stagnated at 30–40% over the past 10–15 years. While there has been an explosion of new therapeutic strategies for metastatic NSCLC in recent years, locally advanced NSCLC is very much in need of innovation.