同步放化疗 (cCRT) 后进行一年的巩固治疗是目前功能状态良好的不可切除的 III 期非小细胞肺癌 (NSCLC) 患者的标准治疗方法。然而，对于临床试验中代表性不足甚至被排除的选定患者群体，cCRT 和巩固 durvalumab 的给药可能具有挑战性：老年和/或体弱的患者；患有心血管或呼吸系统合并症的患者，其中治疗相关的不良事件可能更高，以及患有先前存在的自身免疫性疾病且免疫治疗的使用存在争议的患者。在这篇叙述性综述中，我们讨论了局部晚期 NSCLC 患者相关亚组的当前证据、挑战、正在进行的临床试验以及未来潜在的治疗方案，这些患者在临床试验中代表性不足。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Concurrent chemoradiotherapy (cCRT) followed by one year of consolidation durvalumab is the current standard-of-care for patients with unresectable stage III non-small cell lung cancer (NSCLC), of good functional status. However, cCRT and consolidation durvalumab may be challenging to administer for selected patient populations underrepresented or even excluded in clinical trials: older and/or frail patients; those with cardiovascular or respiratory comorbidities in which treatment-related adverse events may be higher, and patients with pre-existing autoimmune disorders for whom immunotherapy use is controversial. In this narrative review, we discuss the current evidence, challenges, ongoing clinical trials and potential future treatment scenarios in relevant subgroups of patients with locally advanced NSCLC, who are underrepresented in clinical trials.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.