Immune checkpoint inhibitors for advanced non-small cell lung cancer: emerging sequencing for new treatment targets

Area of Science:

• Oncology
• Immunotherapy

Background:

• Lung cancer is a leading cause of cancer mortality worldwide.
• Immune checkpoint inhibitors (ICI) activate anti-tumour immune responses.
• Current ICI use in non-small cell lung cancer (NSCLC) is primarily after chemotherapy failure.

Purpose of the Study:

• To evaluate the efficacy of ICI monotherapy versus chemotherapy for first-line NSCLC treatment.
• To explore alternative strategies for patients with low PD-L1 expression.

Main Methods:

• Comparative study of ICI monotherapy and platinum-based chemotherapy.
• Investigation of combination therapies involving ICI and chemotherapy or other ICIs.

Main Results:

• ICI monotherapy demonstrated superiority over chemotherapy in a subset of patients (30%) with high PD-L1 expression (>50%).
• Limited benefit observed for patients with PD-L1 expression below 50% with current monotherapy approaches.

Conclusions:

• First-line ICI monotherapy offers a survival benefit for a specific NSCLC patient subgroup.
• Combination strategies are under investigation to improve outcomes for patients with lower PD-L1 expression.
• Further research is needed to establish the safety, efficacy, and cost-effectiveness of novel combination therapies.