Dr. Walters on the Best Approach to Treating Patients With Stage III Lung Cancer

Dustin M. Walters, MD, assistant professor, Thoracic and Cardiovascular Surgery, University of Virginia Health System, discusses the best approach to treating patients with stage III lung cancer.

Stage III lung cancer is the most heterogenous and difficult to treat stage of lung cancer. It necessitates a multidisciplinary approach, both in terms of therapeutics and the group of treating physicians. The best therapeutic approach, explains Walters, will be reliant on defining the role of surgery, particularly in light of immunotherapy.

Most physicians at the University of Virginia—and most oncologists in general—will agree that the best approach is going to be some combination of chemoradiation, immunotherapy, and surgery, says Walters. Physicians will have to figure out how to leverage all the benefits of all those therapies and time them appropriately.

It is difficult to say whether one therapeutic approach will be more advantageous than another, explains Walters. Physicians can be sure that the multimodality approach is going to be the best for patients who need local control of their disease. In terms of local control, radiation and surgery will be very useful. However, Walters says that these patients may also need systemic therapy if the disease has metastasized to lymph nodes, as patients will likely have micrometastases and circulating cancer cells.