Is stage 3 cancer curable

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Curability of Stage 3 Cancer: Insights from Recent Research

Stage 3 Non-Small Cell Lung Cancer (NSCLC) Treatment Options

Multimodality Therapy for Stage 3 NSCLC

Stage 3 non-small cell lung cancer (NSCLC) presents a complex challenge due to its heterogeneous nature, ranging from resectable tumors with microscopic nodal metastases to unresectable, bulky nodal disease. Multimodality therapy, which includes a combination of chemotherapy, radiotherapy, and sometimes surgery, is generally preferred for treating stage 3 NSCLC 14. For patients with good performance scores and minimal weight loss, combined chemoradiotherapy has been shown to result in better survival rates compared to radiotherapy alone .

Neoadjuvant and Adjuvant Therapies

Neoadjuvant therapy (treatment given before the main treatment) followed by surgery is an option, but its benefits over definitive chemoradiation are not clearly established. However, platinum-based adjuvant chemotherapy (treatment given after the main treatment) following complete resection of stage IIIA lung cancer is supported by evidence . Additionally, perioperative treatment with nivolumab plus chemotherapy has shown promising results, with higher rates of pathological complete response and longer survival compared to chemotherapy alone .

Immunotherapy for Unresectable Stage 3 NSCLC

For patients with unresectable stage 3 NSCLC, immunotherapy has emerged as a significant treatment option. The PACIFIC study demonstrated that the use of the anti-PD-L1 antibody durvalumab after chemoradiotherapy improved progression-free survival in these patients . This highlights the potential of immunotherapy in managing advanced stages of NSCLC.

Stage 3 Colon Cancer Treatment and Survival

Adjuvant Chemotherapy Duration

In stage 3 colon cancer, the duration of adjuvant chemotherapy has been a subject of investigation. A pooled analysis of six randomized phase 3 trials compared 3 months versus 6 months of adjuvant chemotherapy. The study found that while non-inferiority of the shorter duration was not confirmed, the absolute difference in 5-year overall survival was minimal (0.4%). This suggests that 3 months of adjuvant CAPOX (capecitabine and oxaliplatin) may be sufficient for most patients, reducing toxicities and costs associated with longer treatment .

Conclusion

The curability of stage 3 cancer varies significantly depending on the type and specific characteristics of the cancer. For stage 3 NSCLC, multimodality therapy, including chemoradiotherapy and immunotherapy, offers promising outcomes. In stage 3 colon cancer, shorter durations of adjuvant chemotherapy may be nearly as effective as longer durations, with fewer side effects. While stage 3 cancer remains challenging, advancements in treatment strategies continue to improve survival rates and quality of life for patients.

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Most relevant research papers on this topic

Treatment of stage III non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines.

Multimodality therapy is preferable for most subsets of patients with stage III lung cancer, with combined chemoradiotherapy leading to better survival than radiotherapy alone.

Systematic ReviewHighly Cited

2013·

418citations

·N. Ramnath et al.

Effect of duration of adjuvant chemotherapy for patients with stage III colon cancer (IDEA collaboration): final results from a prospective, pooled analysis of six randomised, phase 3 trials.

Adjuvant chemotherapy for stage III colon cancer patients is effective for both 3 and 6 months, with no significant difference in overall survival rates between the two durations.

Meta-AnalysisRigorous JournalHighly Cited

2020·

166citations

·T. André et al.

Perioperative Nivolumab and Chemotherapy in Stage III Non-Small-Cell Lung Cancer.

Perioperative nivolumab plus chemotherapy leads to a higher percentage of pathological complete response and longer survival than chemotherapy alone in patients with stage IIIA or IIIB non-small-cell lung cancer.

RCTHighly Cited

2023·

163citations

·M. Provencio et al.

The current treatment landscape in the UK for stage III NSCLC

Stage III NSCLC treatment in the UK involves diverse multi-modal treatment options, requiring multi-disciplinary teams to optimize outcomes for patients.

Rigorous JournalHighly Cited

2020·

74citations

·M. Evison

Immunotherapy for Unresectable Stage III Non-Small-Cell Lung Cancer.

Durvalumab shows promise as an effective immunotherapy for unresectable stage III non-small-cell lung cancer, with potential for wider use in the future.

RCTLarge Human TrialRigorous Journal

2017·

40citations

·N. Rizvi et al.

Neoadjuvant chemo-immunotherapy for the treatment of stage IIIA resectable non-small-cell lung cancer (NSCLC): A phase II multicenter exploratory study—Final data of patients who underwent surgical assessment.

Neoadjuvant CT-IO with nivolumab in resectable stage IIIA NSCLC patients yields a high complete pathologic response rate, previously unheard of and unsuspected by RECIST criteria.

Non-RCTRigorous Journal

2019·

59citations

·M. Provencio et al.

Management of Resectable Stage III-N2 Non-Small-Cell Lung Cancer (NSCLC) in the Age of Immunotherapy

Integrating immunotherapy with chemotherapy and radiotherapy shows promise in improving survival rates and curing stage III-N2 non-small-cell lung cancer patients.

Literature ReviewRigorous Journal

2021·

18citations

·X. Mielgo-Rubio et al.

Advances in the Treatment of Stage III Non-Small Cell Lung Cancer.

Durvalumab improves survival in unresectable stage III non-small cell lung cancer patients after completion of definitive concurrent chemoradiation.

2020·

19citations

·N. Myall et al.

Treatment of non-small cell lung cancer-stage IIIA: ACCP evidence-based clinical practice guidelines (2nd edition).

Multimodality therapy is preferable for stage IIIA lung cancer patients, but current randomized trial data is inconclusive, limiting definitive treatment guidelines.

Systematic ReviewHighly Cited

2007·

442citations

·L. Robinson et al.

A randomized trial comparing perioperative chemotherapy and surgery with surgery alone in resectable stage IIIA non-small-cell lung cancer.

Perioperative chemotherapy and surgery are more effective than surgery alone in improving survival rates for patients with resectable stage IIIA non-small-cell lung cancer.

RCTHighly Cited

1994·

1106citations

·J. Roth et al.

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