First-Line Treatment of Non-Small-Cell Lung Cancer (NSCLC) with ImmuneCheckpoint Inhibitors

被引:49
作者
Bylicki, Olivier [1 ]
Barazzutti, Helene [2 ]
Paleiron, Nicolas [2 ]
Margery, Jacques [1 ]
Assie, Jean-Baptiste [3 ]
Chouaid, Christos [3 ]
机构
[1] Hop Instruct Armees Percy, Serv Pneumol, 106 Ave Henri Barbusse, F-92140 Clamart, France
[2] Hop Instruct Armees St Anne, Dept Resp Dis, Toulon, France
[3] Ctr Hosp Intercommunal Creteil, Serv Pneumol, 40 Ave Verdun, F-94010 Creteil, France
关键词
PACLITAXEL PLUS CARBOPLATIN; RANDOMIZED PHASE-III; OPEN-LABEL; STAGE IV; MAINTENANCE BEVACIZUMAB; PD-L1; EXPRESSION; CHEMOTHERAPY; NIVOLUMAB; THERAPY; PEMBROLIZUMAB;
D O I
10.1007/s40259-019-00339-4
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Treatment of advanced-stage or metastatic non-small-cell lung cancers (NSCLCs) without EGFR mutations or ALK rearrangements, which can now be treated with molecularly targeted therapies, had been based on cytotoxic chemotherapy for a long time. Immunecheckpoint inhibitors (ICIs), notably antibodies directed against programmed cell-death protein-1 (PD-1) and its ligand (PD-L1) have transformed therapeutic standards in thoracic oncology. These ICIs are now the reference second-line treatment and numerous phase III trials have examined their efficacy in treatment-naive patients. First-line pembrolizumab monotherapy was validated for patients with50% of tumor cells expressing PD-L1; pembrolizumab, atezolizumab, and nivolumab have obtained good outcomes in combination with chemotherapy or another immunotherapy. However, in this context, other phase III trials yielded negative findings for nivolumab alone (CheckMate-026) or in combination (MYSTIC trial). Biomarkers, such as PD-L1 and the tumor mutation burden (TMB), enable better selection of patients who should benefit the most from first-line ICI use.
引用
收藏
页码:159 / 171
页数:13
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