Immunotherapy in Advanced Non-Small Cell Lung Cancer

Semin Respir Crit Care Med 2020; 41: 400-408 DOI: 10.1055/s-0040-1710077Traditionally, lung cancer has been treated as an immune-resistant disease with platinum-based chemotherapy serving as the first-line treatment for metastatic disease. The efficacy of immunotherapy has been established for patients with advanced lung cancer in clinical trials, and it has since become the standard of care for patients without targetable mutations, with or without chemotherapy. Previously, lung cancer patients experienced limited responses to immune-based therapy. As clinical trials continued to explore immunotherapy options with checkpoint inhibitors, results showed that immune therapies can create durable responses with manageable toxicities. Patients with advanced non-small cell lung cancer (NSCLC) can experience improved survival when administered immunotherapy over chemotherapy. The first successful immunotherapy treatments developed exploit programmed death 1/programmed death ligand 1 (PD-1/PD-L1) and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), immune checkpoint pathways. Combination therapies of PD-1/PD-L1 inhibitors and chemotherapy or PD-1/PD-L1 and CTLA-4 checkpoint pathway inhibitors have also demonstrated improved outcomes for patients with NSCLC. Combination therapy with PD-1 or PD-L1 therapy and chemotherapy has shown benefit for small cell lung cancer patients as well. As immunotherapy changes the treatment paradigm of lung cancer, researchers continue to investigat...
Source: Seminars in Respiratory and Critical Care Medicine - Category: Respiratory Medicine Authors: Tags: Review Article Source Type: research

Related Links:

Authors: Mulherkar R, Grewal AS, Berman AT Abstract Non-small cell lung cancer (NSCLC) accounts for 85% of the cases of lung cancer in the United States, and 70% of patients with NSCLC have locally advanced or metastatic disease at the time of diagnosis. The 5-year overall survival rate for patients with locally advanced NSCLC is 15% to 20%. The traditional treatment paradigm for unresectable locally advanced NSCLC consists of platinum-based chemotherapy with concurrent radiation. Evidence from phase 3 clinical trials has established a role for immunotherapy after chemoradiation, and emerging data continue to eluci...
Source: Clinical Advances in Hematology and Oncology - Category: Cancer & Oncology Tags: Clin Adv Hematol Oncol Source Type: research
Conclusions: The type of treatment was statistically significant in responding to the treatment and treatment side effects but not in the rate of death.
Source: Journal of Cancer - Category: Cancer & Oncology Authors: Tags: Research Paper Source Type: research
Opinion statementIn March 2019, the FDA approved the use of the anti-programmed death ligand 1 (PD-L1) antibody atezolizumab, as a first-line treatment option in combination with platinum-etoposide (PE) for patients with extensive stage small cell lung cancer (ED SCLC) based upon the results of the IMpower133 trial. More recently, the FDA approved the anti-PD-L1 antibody durvalumab in March 2020 , also in the frontline setting for SCLC based upon the results of the CASPIAN trial. Both these trials demonstrated a small, but significant overall survival (OS) benefit with the addition of a PD-L1 antibody to standard chemother...
Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research
ConclusionAt the time of this analysis, most patients who received more than one ALK TKI received crizotinib as the initial ALK TKI. Additional ALK TKIs have since been approved in Japan as first-line or later therapeutic options for patients with ALK-positive NSCLC, but the optimal sequence of ALK TKI usage remains undetermined. As new data continue to emerge, additional research will be warranted to evaluate ALK TKI sequences that do not include crizotinib as the first therapy in this patient population.
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research
Opinion statementPatients with stage IV or recurrent/metastatic non-small cell lung cancer (NSCLC) whose tumors harbor high PD-L1 expression and driver mutations with approved targeted treatments (EGFR,ALK,BRAFV600E,ROS1) should receive initial therapy with targeted therapy based on impressive clinical activity. PD-(L)1 inhibitors have demonstrated minimal activity in many driver mutation subsets includingEGFR andALK and appears to have more benefit in smoking-associated oncogenic drivers (KRAS,BRAF). ForKRAS-driven tumors, co-mutations such asSTK11/LKB1 are negative predictive markers of immunotherapy with or without chem...
Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research
We present a case of first-line ICI-chemotherapy in a patient with metastatic NSCLC and ILD who suffered treatment related lung toxicity and acute worsening ILD, which lead to his death. PMID: 32559143 [PubMed - as supplied by publisher]
Source: Cancer Investigation - Category: Cancer & Oncology Tags: Cancer Invest Source Type: research
Patients with pleural mesothelioma cancer may have another treatment option after the U.S. Food and Drug Administration approved the use of pembrolizumab for certain metastatic tumors this week. Pembrolizumab, often known by the brand name Keytruda, is a well-known immunotherapy drug already being used with mixed success for several cancers. This latest FDA approval is for the treatment of adult and pediatric cancers with unresectable disease and high mutational burden that have progressed following prior treatment and have no alternative treatment options. A number of mesothelioma patients already are being treated with p...
Source: Asbestos and Mesothelioma News - Category: Environmental Health Authors: Source Type: news
Lung cancer is the leading cause of cancer-related deaths worldwide. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of lung cancer is divided mainly into lung squamous cell carcinoma (LUSC), lung adenocarcinoma (LUAD), and large cell carcinoma (LCC) [1]. Although great progress has been made in targeted treatment and immunotherapy, Platinum-based combination chemotherapy is still the standard chemotherapy treatment for wild type lung adenocarcinoma, and cisplatin (DDP) is widely used [2,3].
Source: Lung Cancer - Category: Cancer & Oncology Authors: Source Type: research
Lung cancer is the leading cause of cancer death worldwide as well as in China. For many years, conventional oncologic treatments such as surgery, chemotherapy, and radiotherapy (RT) have dominated the field of non-small cell lung cancer (NSCLC). The recent introduction of immunotherapy in clinical practice, led to a paradigm shift in lung cancer as in many other solid tumors. Recent pre-clinical and clinical data have shown RT may also modify antitumor immune responses through induction of immunogenic cell death and reprogramming of the tumor microenvironment. This has led many to reexamine RT as a partner therapy to immu...
Source: Chinese Journal of Lung Cancer - Category: Cancer & Oncology Source Type: research
Background: Serum tumor markers carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), cytokeratin 19 fragment (CYFRA21-1) and squamous-cell carcinoma-related antigen (SCC-Ag) are routinely used for monitoring the response to chemotherapy or targeted therapy in advanced-stage non-small cell lung cancer (NSCLC), however their role in immunotherapy remains unclear. The aim of this study was to investigate whether dynamics of these serum markers were associated with the efficacy and prognosis of Chinese late-stage NSCLC patients treated with programmed cell death-1/programmed cell death ligand-1 (PD-1/PD-L1) inhibitors.M...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
More News: Cancer | Cancer & Oncology | Chemotherapy | Clinical Trials | Immunotherapy | Lung Cancer | Non-Small Cell Lung Cancer | Respiratory Medicine | Toxicology