Multidisciplinary approach for patients with early and locally advanced non-small cell lung cancer (NSCLC): 2nd Spanish Lung Cancer Group (GECP) expert consensus statement

Abstract

Background: In light of the ongoing advancements in the treatment of patients with early- and locally advanced-stage non-small cell lung cancer (NSCLC), the members of the Spanish Lung Cancer Group (GECP) deemed it necessary to update its 2023 consensus suggestions for the management of these patients. Methods: From July to November 2024, a panel of experts, including thoracic surgeons, radiation oncologists, and medical oncologists, was convened. The consensus process was developed using a mixed approach that incorporated Delphi and nominal group techniques. The consensus coordination group reviewed the relevant scientific literature for the update and developed a questionnaire for the panel of experts to vote on. Two rounds of voting were conducted, followed by a final nominal group meeting to discuss clinical situations where consensus had not been reached and draw final conclusions. In instances where high-quality scientific data were not available or were the subject of controversy, final suggestions were based on the expertise of the participants. Results: Thirty experts from the multidisciplinary team participated in the voting and discussions. The document was updated to incorporate recent advancements in molecular diagnosis and biomarkers, the role of the multidisciplinary thoracic committee, criteria for neoadjuvant/perioperative treatment, approaches to inoperable/unresectable disease, and adjuvant treatment. Proposals that did not require updating were not voted on again and remain part of the document, maintaining their first version. Conclusions: Updated suggestions were developed for the most relevant situations in the treatment of patients with early-stage and locally advanced NSCLC. These suggestions will support clinical decisionmaking in daily practice. This paper presents the statements developed by the expert panel and summarizes the scientific evidence supporting them.