The Best Supportive Care in Stage III Non-Small-Cell Lung Cancer

Round 1

Reviewer 1 Report (Previous Reviewer 1)

Comments and Suggestions for Authors Ok for me

available for publication

Reviewer 2 Report (Previous Reviewer 5)

Comments and Suggestions for Authors

The authors answered my comments and questions.

I am satisfied with the new version of the manuscript.

This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Very important and complet eanalysis but the manuscript is difficult to read

My advice is to move as supllementary materiel the majority of the tables and to keep on main manuscript only the text. It will be much more eaisier to read

Author Response

Thank you for the comments. We moved the tables 2, 3, 4, 5 and 6 to supplementary material.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

This article is a comprehensive and important review of the utility of supportive care and MDT in chemoradiation therapy. I found it very informative. I salute the authors for their efforts.

No major comments.

On a minor point, regarding the regimen in Table 3, the most recent NCCN guidelines state as a note that additional chemotherapy after completion of radiation is not recommended when durvalumab is indicated, and I do not believe the note should be omitted in this paper.

Line 102 3.799 → 3,799

Line 123 10.072 → 10,072

Line 180 2.000 → 2,000

Author Response

Thank you for your commentary. The modifications suggested for you were performed in the revised version of the manuscript.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The author reviewed the current MTD based treatment strategy for stage III NSCLC.

-       Please kindly cut down the length of the paper. There is repetition in Table 1 and Table 2 and the description.

-       If the author is discussing Stage III NSCLC, the neoadjuvant chemo/IO or perioperative immunotherapy should also be discussed.  

-       Some of the font looks not consistent. Table 1 – the critical role of MDT for implementing immunotherapy based consolidation ‘the pacific trial….’, as well as the paragraph above table 2 “in a real-world cohort of stage III NSCLC”.

-       Consider making Table 2 more concise. Perhaps 2 separate columns with one for recommendation and the other column for evidence. The current format is difficult to read.

-       Line 40 – 3,278 patients? Not 3.278

-       Line 215- author should also mention immunotherapy-mediated pneumonitis.

-       Table 4 – make it more concise - consider using bullet points. If the author is trying to describe MTD role, it would be helpful just to list the MTD role from each specialty/role.

-       Table 6 – consider making it more succinct.

Comments on the Quality of English Language

No significant issue found

Author Response

Thank you for the opportunity to review the manuscript. All comments and suggestions were carefully considered in the preparation of the revised version of our manuscript. 

Reviewer 4 Report

Comments and Suggestions for Authors

Thiago Bueno Oliveira et al. are describing a review article regarding Best Supportive Care in Stage III Non-Small-Cell Lung-Cancer.

Interesting article that discuss the efficacy of MDT-based approaches on the improvement of outcomes and management of unresectable stage III NSCLC.

In which its describing the important of MDT and its impact on survival, Enteral and Parenteral nutritional, Physical activity, Navigating nursing and so…

I think that this review has very important information's to add for us as oncologist which included several types of things such as BSC and AE.  

Just 2 comments:

-1 Regarding the maintenance therapy of durvalumab and the DT discussion in the following article, which is a work from different countries (11 European countries): Real-World Journey of Unresectable Stage III NSCLC Patients: Current Dilemmas for Disease Staging and Treatment - PubMed (nih.gov) (Agbarya, Abed et al. “Real-World Journey of Unresectable Stage III NSCLC Patients: Current Dilemmas for Disease Staging and Treatment.” Journal of clinical medicine vol. 11,6 1738. 21 Mar. 2022, doi:10.3390/jcm11061738) from this article 

You can find more information's to be added such as dilemmas for oncologists and efficacy of MDT for choosing terapy .

2-From the abstract delete "PURPOSE:" in which references should be arranged as journal asking [1] and not 1

Author Response

Thank you for the considerations. All modifications and inclusion of informations suggested for you were performed in the revised version of the manuscript.

Reviewer 5 Report

Comments and Suggestions for Authors

This is a very comprehensive paper on MDTs for stage III NSCLC, but it mainly focus on unresectable patients and it should be stated more clearly. In the introduction, when options are discussed to treat stage III NSCLC patients, perioperative immunotherapy should be added. In the composition of the MDT in the introduction, pathologists should be added too.

The paper is very long and there is some repetition between the text and tables. I think table 2 and 6 could be supplements and not in the paper itself.

Comments on the Quality of English Language

There are minor issues, such as verb tenses that will sometimes alternate between past and present in a same paragraph.

Author Response

Thank you for the commentary, all suggestions were made. We reviewed the quality of the English Language and applied corrections to the new version of the manuscript.