Current controversies and challenges in unresectable stage III NSCLC

Unresectable stage III NSCLC is clinically heterogeneous and therapeutically challenging. Although the PACIFIC regimen defines the current standard of care, more than half of patients fail to achieve long-term control. Concurrent immunotherapy with chemoradiotherapy has not proven superior to standard consolidation, while induction, surgical conversion, and de-escalation strategies remain insufficiently validated. This review critically appraises these controversies, molecular stratification, and the key questions future trials must address.