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Semi-automatic PD-L1 Characterization and Enumeration of Circulating Tumor Cells from Non-small Cell Lung Cancer Patients by Immunofluorescence
Published on: August 14, 2019
Immune checkpoint inhibitors and small cell lung cancer: what's new?
1Department of Oncology, Haematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Abstract:
Despite extensive research no meaningful progress in systemic treatment of small cell lung cancer (SCLC) has been made in the past decades. Earlier attempts with immunotherapy including interferon and vaccination approaches had limited success. High mutational load, smoking history and potentially also the frequent presence of paraneoplastic phenomena-indicating an activated immune system-represent a rationale for a benefit from immune checkpoint inhibitors in SCLC. However, the likelihood of response is diminished due to poor T-cell activation resulting from low expression of MHC class I antigens, low amounts of tumor infiltrating lymphocytes (TILs) and low PD-L1 expression rates. Recently, early reports from studies with checkpoint inhibitors have shown promising results with the potential for long term disease control in a subset of SCLC patients. However, reliable predictive biomarkers to better define the population drawing most benefit are currently lacking. Results from ongoing phase III trials in different treatment lines and in the maintenance setting are eagerly awaited.
Insights
Systemic treatment for small cell lung cancer (SCLC) has seen limited progress. Immune checkpoint inhibitors show promise for a subset of patients, but biomarkers are needed to identify who will benefit most.
Area of Science:
- Oncology
- Immunotherapy
- Lung Cancer Research
Background:
- Small cell lung cancer (SCLC) has lacked meaningful treatment advances for decades.
- Previous immunotherapy attempts yielded limited success.
- Rationale for immune checkpoint inhibitors includes high mutational load and smoking history in SCLC.
Purpose of the Study:
- To review the current status and future prospects of immune checkpoint inhibitors in small cell lung cancer treatment.
- To identify challenges and unmet needs in predicting response to immunotherapy in SCLC.
Main Methods:
- Review of recent clinical trial data and scientific literature on immune checkpoint inhibitors in SCLC.
- Analysis of factors influencing T-cell activation and response to immunotherapy.
Main Results:
- Early reports show promising results for immune checkpoint inhibitors in a subset of SCLC patients.
- Response likelihood is often diminished by low MHC class I expression, low tumor-infiltrating lymphocytes (TILs), and low PD-L1 expression.
- Reliable predictive biomarkers for treatment benefit are currently lacking.
Conclusions:
- Immune checkpoint inhibitors offer potential for long-term disease control in some SCLC patients.
- Further research and development of predictive biomarkers are crucial for optimizing SCLC immunotherapy.
- Ongoing phase III trials are anticipated to provide critical data for various treatment settings.
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