The evolving immuno-oncology landscape in advanced lung cancer: first-line treatment of non-small cell lung cancer

Lung cancer is the most common cancer and leading cause of cancer death. While targeted therapies have redefined treatment options for non-small cell lung carcinoma (NSCLC) with genetic aberrations such as epidermal growth factor and anaplastic lymphoma kinase, many patients do not harbour these oncogenic drivers. Cancer immunology has enabled the development of immune modulators that has dramatically altered the therapeutic landscape of advanced NSCLC. The success of immune-checkpoint inhibitors in pretreated NSCLC has led to the conduct of multiple studies exploring their role in the first-line setting. This article provides an overview of the evolving landscape of immune-checkpoint inhibitors with a focus on the programmed cell-death 1 (PD-1; pembrolizumab, nivolumab) and programmed cell-death ligand 1 (PD-L1; atezolizumab, durvalumab, avelumab) immune-checkpoint inhibitors as single agent or in combination with either chemotherapy or with another immune-checkpoint inhibitor in the treatment of NSCLC, the challenges faced, as well as future perspectives.

Download Full-text

Association of Programmed Cell Death Ligand 1 Expression Status With Receipt of Immune Checkpoint Inhibitors in Patients With Advanced Non–Small Cell Lung Cancer

JAMA Network Open ◽

10.1001/jamanetworkopen.2020.7205 ◽

2020 ◽

Vol 3 (6) ◽

pp. e207205 ◽

Cited By ~ 1

Author(s):

Michael S. Leapman ◽

Carolyn J. Presley ◽

Weiwei Zhu ◽

Pamela R. Soulos ◽

Kerin B. Adelson ◽

...

Keyword(s):

Lung Cancer ◽

Cell Death ◽

Programmed Cell Death ◽

Small Cell Lung Cancer ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Small Cell ◽

Small Cell Lung ◽

Expression Status

Download Full-text

A single institution study evaluating outcomes of PD-L1 high KRAS-mutant advanced non-small cell lung cancer (NSCLC) patients treated with first line immune checkpoint inhibitors

Cancer Treatment and Research Communications ◽

10.1016/j.ctarc.2021.100330 ◽

2021 ◽

Vol 27 ◽

pp. 100330 ◽

Cited By ~ 1

Author(s):

Adi Kartolo ◽

Harriet Feilotter ◽

Wilma Hopman ◽

Andrea S. Fung ◽

Andrew Robinson

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Small Cell ◽

Small Cell Lung ◽

Single Institution ◽

First Line ◽

Nsclc Patients

Download Full-text

Immune checkpoint inhibitors as first-line and salvage therapy for advanced non-small-cell lung cancer

Future Oncology ◽

10.2217/fon-2016-0086 ◽

2016 ◽

Vol 12 (15) ◽

pp. 1805-1822 ◽

Cited By ~ 3

Author(s):

Marios P Decatris ◽

Kenneth J O'Byrne

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Immune Checkpoint ◽

Salvage Therapy ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Small Cell ◽

Small Cell Lung ◽

First Line

Download Full-text

Immune checkpoint inhibitors plus chemotherapy versus chemotherapy or immunotherapy for first-line treatment of advanced non-small cell lung cancer: a generic protocol

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd013009 ◽

2018 ◽

Cited By ~ 1

Author(s):

Nicholas LX Syn ◽

Raheleh Roudi ◽

Louis Zizhao Wang ◽

Lingzhi Wang ◽

Marie Loh ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Small Cell ◽

Line Treatment ◽

Small Cell Lung ◽

First Line ◽

First Line Treatment

Download Full-text

Treatment- and immune-related adverse events of immune checkpoint inhibitors in advanced lung cancer

Bioscience Reports ◽

10.1042/bsr20192347 ◽

2020 ◽

Vol 40 (5) ◽

Cited By ~ 2

Author(s):

Jun Shao ◽

Chengdi Wang ◽

Pengwei Ren ◽

Yuting Jiang ◽

Panwen Tian ◽

...

Keyword(s):

Lung Cancer ◽

Adverse Events ◽

Small Cell Lung Cancer ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Small Cell ◽

Advanced Lung Cancer ◽

Small Cell Lung ◽

Organ Specific

Abstract Background: Immune checkpoint inhibitors (ICIs) emerged as the preferred therapy in advanced lung cancer, understanding the treatment- and immune-related adverse events of these drugs is of great significance for clinical practice. Materials and methods: PubMed, Embase, Cochrane library and major conference proceedings were systematically searched for all randomized controlled trials (RCTs) in lung cancer using PD-1/PD-L1/CTLA-4 inhibitors. The outcomes included treatment-related adverse events (TRAEs) and several organ specific immune-related adverse events (IRAEs). Results: 24 RCTs involving 14,256 patients were included. There was a significant difference for ICI therapy in the incidence of any grade of TRAEs (RR: 0.90; 95%CI: 0.84–0.95; P=0.001) and a lower frequency of grade 3-5 of TRAEs (RR: 0.65; 95%CI: 0.51–0.82; P<0.001). Patients treated with ICI therapy in non–small-cell lung cancer (NSCLC) were less reported TRAEs than in small cell lung cancer (SCLC). A lower risk of TRAEs was favored by anti-PD-1 inhibitors over anti-PD-L1 antibodies and anti-CTLA-4 drugs. The most common organ specific IRAE was hypothyroidism that occurred 8.7%. The incidence of pneumonitis and hepatitis reached 4.5% and 4.0% respectively. Compared with patients treated in control arms, those treated with ICI drugs were at higher risk for each organ specific adverse event including colitis, hepatitis, pneumonitis, hypothyroidism and hypophysitis. Conclusions: ICI therapy was safer than chemotherapy, especially ICI monotherapy such as anti-PD-1 antibodies in NSCLC. Compared with standard treatments, ICI drugs increased the risk of organ-specific IRAEs, although the overall incidence remained low.

Download Full-text