First-Line Immune Checkpoint Inhibition for Advanced Non-Small-Cell Lung Cancer: State of the Art and Future Directions
- PDF / 1,172,263 Bytes
- 15 Pages / 595.276 x 790.866 pts Page_size
- 7 Downloads / 144 Views
REVIEW ARTICLE
First‑Line Immune Checkpoint Inhibition for Advanced Non‑Small‑Cell Lung Cancer: State of the Art and Future Directions Christoph Jakob Ackermann1 · Helen Adderley2 · Ana Ortega‑Franco2 · Adeel Khan2 · Martin Reck3 · Raffaele Califano2,4,5
© Springer Nature Switzerland AG 2020
Abstract The advent of PD-(L)1 and CTLA-4 immune check point inhibitors (CPIs) has dramatically changed the treatment landscape of advanced non-small-cell lung cancer (NSCLC). For up to a quarter of patients with advanced NSCLC, CPIs have the potential to induce durable responses with long-term survival outcomes. Since the approval of first-line pembrolizumab for patients whose tumors express a PD-L1 ≥ 50%, several pivotal first-line CPI-based phase 3 studies have been conducted investigating combination treatments combining CPIs with chemotherapy (ChT) or combining different CPIs with or without ChT. As a result, there has been an increase in front-line treatment options for advanced NSCLC, and treatment algorithms are changing very quickly. In fit patients with advanced NSCLC, combination treatments including CPI and ChT are considered the new standard of care with improved clinical outcomes. CPI combination treatments are well tolerated and quality of life also seems to be better when CPIs are implemented in the first-line setting. The aim of this review is to provide a summary of the recently published first-line phase 3 studies investigating CPIs as monotherapy or in combination with other CPIs or ChT in advanced NSCLC, and to suggest possible treatment algorithms.
1 Introduction The discovery of targeted therapies for specific oncogenic molecular aberrations has led to new therapy options and significant improvements in outcomes for a subset of patients with advanced non-small-cell lung cancer (NSCLC). However, only a minority of patients will have tumors harboring an actionable oncogenic driver, and therefore chemotherapy (ChT) with or without bevacizumab represented the standard of care for several years. The emergence of immunotherapies * Raffaele Califano [email protected] 1
Department of Medical Oncology, Spital STS AG, Thun, Switzerland
2
Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, UK
3
Department of Thoracic Oncology, Airway Research Center North (ARCN), German Center for Lung Research, LungenClinic Grosshansdorf, Grosshansdorf, Germany
4
Department of Medical Oncology, Manchester University NHS Foundation Trust, Manchester, UK
5
Division of Cancer Sciences, University of Manchester, Manchester, UK
with check point inhibitors (CPI) and CPI-ChT combinations have radically transformed advanced NSCLC care, leading to revised treatment algorithms. In particular, the use of programmed cell death protein (ligand) 1 (PD-(L)1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA4) CPI induced a paradigm shift in lung cancer care with the unprecedent potential of those drugs to induce durable responses and long survival outcomes for
Data Loading...
