Dr. Nasser Hanna, Indiana University Health, reviews efforts to utilize targeted therapies as consolidation after chemoradiation in locally advanced NSCLC.

Dr. Nasser Hanna, Indiana University Health, considers the use of induction or consolidation chemotherapy for unresectable stage III NSCLC.

Dr. Mark Socinski, University of Pittsburgh Medical Center, discusses the benefits of giving two additional cycles of chemotherapy in combination with radiotherapy for stage III NSCLC.

There are many open questions in managing lung cancer, but one of our historical areas that has been especially challenging has been locally advanced/stage III NSCLC, which we most commonly treat with at least two different forms of therapy, such as chemotherapy followed by surgery, chemo and radiation followed by surgery, or (most commonly) chemotherapy and radiation without surgery. Why is it such a controversial area?

Dr. Jack West, medical oncologist at Swedish Cancer Institute in Seattle, Washington, talks about the right amount of chemotherapy for patients with locally advanced, non-small cell lung cancer. For more information, visit www.swedish.org/lungcancer

When I was a medical student, the question about lung cancer that was always asked on "the Boards" had to do with the difference between stage IIIA and stage IIIB non-small cell lung cancer (NSCLC). The reason this question was always asked is because patients with stage IIIA NSCLC might be considered for surgery, whereas patients with stage IIIB NSCLC would not be considered for surgery and instead would be treated with chemotherapy and radiation. The idea is that young doctors should be able to make that distinction and to direct patients to the appropriate specialist/treatment.

Here is the third and final case I discussed with two great experts in locally advanced NSCLC. Drs. George Blumenschein, medical oncologist from MD Anderson Cancer Center in Houston, and Wally Curran, radiation oncologist from Winship Cancer Center at Emory University in Atlanta, joined me several weeks ago to discuss a series of challenging cases that illustrate the complexities and array of options in treating patients with stage III NSCLC.

Dr. Suresh Ramalingam is a longtime friend of mine and a national leader in the field of lung cancer. He is the Director of the Lung Cancer Program at the Winship Cancer Institute at Emory University in Atlanta, and he was kind enough to sit down with me to talk about his perspective on the current optimal treatment for patients with stage III, or locally advanced, NSCLC. We also spoke about managing metastatic disease, which will be covered in a separate podcast. It's an audio interview, but if people watch the video version, there are some figures synchronized with the discussion.