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Second-line treatment for advanced NSCLC without actionable mutations: is immunotherapy the 'panacea' for all

Alessandro Morabito1

  • 1The Medical Oncology Unit, Thoracic-Pulmonary Department, Istituto Nazionale Tumori, "Fondazione G. Pascale" - IRCCS, Via Mariano Semola, 80131, Naples, Italy. a.morabito@istitutotumori.na.it.

BMC Medicine
|February 17, 2018
PubMed

Insights

Second-line immunotherapy shows promise for advanced non-small cell lung cancer (NSCLC) patients without actionable mutations. However, predictive biomarkers are crucial for identifying patients who will benefit from these novel treatments.

Area of Science:

  • Oncology
  • Pharmacology
  • Biomarkers

Background:

  • Second-line treatment for advanced non-small cell lung cancer (NSCLC) has evolved with new drugs like nintedanib, ramucirumab, nivolumab, pembrolizumab, atezolizumab, and afatinib.
  • A network meta-analysis by Créquit et al. compared second-line treatments for NSCLC with wild-type or unknown EGFR status.

Purpose of the Study:

  • To evaluate the effectiveness and tolerability of second-line treatments for advanced NSCLC.
  • To highlight the importance of predictive biomarkers in guiding treatment decisions for immunotherapy.

Main Methods:

  • Network meta-analysis comparing various second-line therapies for advanced NSCLC.
  • Analysis focused on patients with wild-type or unknown epidermal growth factor receptor (EGFR) status.

Main Results:

  • Immunotherapy may be more effective than currently recommended treatments for advanced NSCLC.
  • The meta-analysis did not account for predictive biomarkers, which are essential for patient selection.

Conclusions:

  • Identifying molecular biomarkers is critical to maximize the benefits of immune checkpoint, angiogenesis, and EGFR inhibitors in NSCLC.
  • Biomarker research is needed to aid clinicians in selecting optimal second-line therapies for advanced NSCLC patients.
Keywords:
AfatinibAtezolizumabDocetaxelErlotinibNSCLCNintedanibNivolumabPembrolizumabPemetrexedRamucirumabSecond-line therapy

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