Resumen de Multidisciplinary approach for locally advanced non‑small cell lung cancer (NSCLC): 2023 expert consensus of the Spanish Lung Cancer Group GECP
Aylen Vanessa Ospina Serrano, Mariano Provencio Pulla, Sergio Bolufer Nadal, José Luis Campo Cañaveral de la Cruz, V. Calvo de Juan, José Luis González Larriba, Florentino Hernando Trancho, José Ramón Jarabo Sarceda, Ivan Macia Vidueira, Bartomeu Massuti Sureda, E. Nadal, Antonio Álvarez Kindelan, Edel del Barco Morillo, Reyes Bernabé-Caro, Joaquim Bosch Barrera, Joaquín Casal Rubio, Javier de Castro Carpeño, Ángel Cilleruelo Ramos, Manuel Cobo Dols, Manuel Dómine Gómez, Santiago Figueroa Almánzar, María Rosario García Campelo, Amelia Insa Mollá, Unai Jiménez Maestre, R. Lopez Castro, Margarita Majem, Elisabeth Martínez Téllez, Alex Martínez, David Sanchez Lorente
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 defnition of discussion topics 2. First round of voting 3. Communicating the results and second round of voting 4. Defnition of conclusions in nominal group meeting. Responses were consolidated using medians and interquartile ranges. The threshold for agreement was defned 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.
