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Combination approaches in NSCLC involving immune checkpoint inhibitors
Surein Arulananda1,1, Gareth Rivalland1,1, Thomas John1,2,1,2
1Olivia Newton John Cancer Centre, Austin Health, Heidelberg, Australia.
Abstract:
Immune checkpoint inhibition has been proven to be highly efficacious in NSCLC and associated with durable responses in a limited number of patients. Chemotherapy and targeted therapies, which have also expanded rapidly in this field lead to high response rates and improved survival although inevitably resistance occurs and hence treatment failure. There is increasing evidence showing that chemotherapy and targeted therapy interplay with the immune system including exerting effects on tumor cells and the host immune cells. Naturally combining both of these treatment modalities to induce cytotoxic effects on tumor cells to release tumor antigens and priming of the immune system should in turn lead to enhanced anticancer activity. This review will explore some of the preclinical rationale and clinical trial data we have to date on combining various systemic therapies with immunotherapies.
Insights
Combining systemic therapies like chemotherapy with immune checkpoint inhibitors shows promise for non-small cell lung cancer (NSCLC). This approach aims to enhance anti-cancer activity by stimulating the immune system against tumors.
Area of Science:
- Oncology
- Immunology
- Pharmacology
Background:
- Immune checkpoint inhibition is effective in non-small cell lung cancer (NSCLC), yielding durable responses in some patients.
- Chemotherapy and targeted therapies improve response rates and survival in NSCLC but face inevitable resistance.
- Emerging evidence highlights the immunomodulatory effects of chemotherapy and targeted therapy on tumor and host immune cells.
Purpose of the Study:
- To review the preclinical rationale for combining systemic therapies with immunotherapies in NSCLC.
- To examine existing clinical trial data on these combination strategies.
- To explore the potential for enhanced anti-cancer activity through combined treatment modalities.
Main Methods:
- Literature review of preclinical studies.
- Analysis of clinical trial data on combination therapies.
- Exploration of the interplay between systemic therapies and the immune system.
Main Results:
- Preclinical data support the rationale for combining cytotoxic agents with immunotherapies.
- Clinical trials are investigating various combinations of chemotherapy, targeted therapy, and immune checkpoint inhibitors.
- Combined approaches aim to increase tumor antigen release and enhance immune priming.
Conclusions:
- Combining systemic therapies with immunotherapies represents a promising strategy for NSCLC treatment.
- This approach has the potential to overcome resistance and improve patient outcomes.
- Further clinical investigation is warranted to optimize these combination regimens.
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