The changing scenario of 1 st line therapy in non-oncogene addicted NSCLCs in the era of immunotherapy

Crit Rev Oncol Hematol. 2018 Oct;130:1-12. doi: 10.1016/j.critrevonc.2018.06.007. Epub 2018 Jun 18.

Abstract

During the last two decades front-line treatment of metastatic Non Small Cell Lung Cancer (NSCLC) has profoundly changed moving from the old "one size fits all" concept to a "histology-based" approach and then, for a small subgroup of patients to a "molecularly-selected" one. The development of immune checkpoint inhibitors and the unprecedented results reported in 2nd/3rd line prompted the evaluation of these novel therapeutic agents in chemotherapy-naïve patients either alone or in combination with platinum-based chemotherapy. Several randomized trials are evaluating the impact of immune-checkpoint inhibitors in 1st line and some of them have yet produced preliminary evidence of efficacy. However, still a long way to go and several questions are still unanswered, including proper patients selection, optimal sequential/combinatorial use of these agents, appropriate treatment duration, and finally the identification of predictive biomarkers. The aim of this paper is to provide a comprehensive overview on the growing role of immune checkpoint inhibitors in the upfront treatment of advanced non-oncogene addicted NSCLC either as single agent or in combination with other agents.

Keywords: Atezolizumab; Avelumab; Durvalumab; First line; Immunotherapy; NSCLC; Nivolumab; Pembrolizumab.

Publication types

  • Review

MeSH terms

  • Animals
  • Antibodies, Monoclonal / therapeutic use*
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Humans
  • Immunotherapy / methods*
  • Lung Neoplasms / drug therapy*

Substances

  • Antibodies, Monoclonal