Immune Netw.  2020 Feb;20(1):e10. 10.4110/in.2020.20.e10.

Immunotherapy for Non-small Cell Lung Cancer: Current Landscape and Future Perspectives

Affiliations
  • 1Division of Hematology-Medical Oncology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
  • 2Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. nobelg@yuhs.ac

Abstract

Immune checkpoint inhibitors (ICIs) have shown remarkable benefit in the treatment of patients with non-small-cell lung cancer (NSCLC) and have emerged as an effective treatment option even in the first-line setting. ICIs can block inhibitory pathways that restrain the immune response against cancer, restoring and sustaining antitumor immunity. Currently, there are 4 PD-1/PD-L1 blocking agents available in clinics, and immunotherapy-based regimen alone or in combination with chemotherapy is now preferred option. Combination trials assessing combination of ICIs with chemotherapy, targeted therapy and other immunotherapy are ongoing. Controversies remain regarding the use of ICIs in targetable oncogene-addicted subpopulations, but their initial treatment recommendations remained unchanged, with specific tyrosine kinase inhibitors as the choice. For the majority of patients without targetable driver oncogenes, deciding between therapeutic options can be difficult due to lack of direct cross-comparison studies. There are continuous efforts to find predictive biomarkers to find those who respond better to ICIs. PD-L1 protein expressions by immunohistochemistry and tumor mutational burden have emerged as most well-validated biomarkers in multiple clinical trials. However, there still is a need to improve patient selection, and to establish the most effective concurrent or sequential combination therapies in different NSCLC clinical settings. In this review, we will introduce currently used ICIs in NSCLC and analyze most recent trials, and finally discuss how, when and for whom ICIs can be used to provide promising avenues for lung cancer treatment.

Keyword

Non-small cell lung cancer; Immunotherapy; Programmed cell death protein 1

MeSH Terms

Biomarkers
Carcinoma, Non-Small-Cell Lung*
Drug Therapy
Humans
Immunohistochemistry
Immunotherapy*
Lung Neoplasms
Oncogenes
Patient Selection
Protein-Tyrosine Kinases
Biomarkers
Protein-Tyrosine Kinases
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