AUTHOR=Carcereny Enric , Domine Manuel , Ortega Granados Ana Laura TITLE=Defining long-term survivors in metastatic lung cancer: insights from a Delphi study in Spain JOURNAL=Frontiers in Oncology VOLUME=Volume 15 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1546019 DOI=10.3389/fonc.2025.1546019 ISSN=2234-943X ABSTRACT=The improvement in survival rates in metastatic lung cancer (mLC) has increased the number of survivors’ special care needs. This study aimed to define and characterise these long-term survivors. A Delphi method with two successive rounds was conducted to reach a consensus (defined as an agreement ≥ 70%) on 56 items among 41 medical oncologists. The items included the definition of long-term survivors, their common characteristics, and oncological and non-oncological implications. The experts had an average age of 46 years, 53.7% were men, 90.2% attended for thoracic tumours, 40% had more than 15 years’ experience in mLC, and 56.1% of managing > 50 patients/month. Consensus reached 53.6% in the first round and 73.2% in the second. The definition of long-term survivors reached 58.3% consensus, defined as overall survival ≥ 3 years and/or progression-free survival ≥ 2 years. Identification of common features obtained 76.2% consensus on adenocarcinoma subtype of non-small-cell lung cancer, high PD-L1 expression, absence of brain metastasis, and fewer than two metastatic locations. Consensus was reached on specialized medical follow-up to detect immune-mediated toxicities and second neoplasms (87.8%), on pharmacological/non-pharmacological treatment for fatigue (82.9%) and sexual dysfunction (85.4%); and also on the importance of support for work and social adaptation (92.7%), integration of primary and hospital care (90.2%), implementation of quality-of-life programmes (92.7%) and electronic media (73.2%). This consensus identifies common characteristics and highlights relevant implications that should guide the follow-up and clinical management of these patients, ensuring better care and quality of life.