The progress that has been made in the last decades in the treatment of stage IV non-small cell lung cancer (NSCLC) has overall not been translated to the curative setting of stage I to III disease. In fact, the list of failed clinical trials aimed at improving the cure rates in this setting is long. The successes with immune checkpoint inhibition in stage IV NSCLC formed the basis to also study these agents in the curative NSCLC setting. Several studies are underway evaluating the potential of adjuvant immune checkpoint inhibition in stage II and IIIA disease and promising data have also been generated in the pre-operative setting. In addition to that, immune checkpoint inhibition is also being studied as consolidation treatment following chemoradiotherapy in locally advanced, unresectable NSCLC. The PACIFIC trial forms the first of these studies to yield results and showed that the PD-L1 inhibitor durvalumab significantly prolongs the progression-free survival (PFS) compared to placebo in patients with locally advanced, unresectable stage III NSCLC. More mature (overall survival, OS) results of this study are eagerly awaited as are the results of the other clinical studies evaluating immune checkpoint inhibitors in the curative NSCLC setting.
