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Published on: September 25, 2018
Are anti-PD1 and anti-PD-L1 alike? The non-small-cell lung cancer paradigm
Giuseppe Luigi Banna1, Ornella Cantale1, Melissa Bersanelli2
1Deparment of Medical Oncology, Portsmouth Hospitals NHS Trust, United kingdom.
Abstract:
Anti-PD1 and anti-PD-L1 agents may have intrinsic and clinically relevant differences in the treatment of non-small cell lung cancer (NSCLC) patients. By reviewing currently available indirect evidence on these agents for NSCLC treatment, highlighting possible inter- and intra-class dissimilarities, anti-PD1 agents showed a higher response rate and a better outcome when combined with chemotherapy for the first-line treatment of patients with squamous and PD-L1 low advanced NSCLC, as compared to anti-PD-L1 agents. Conversely, anti-PD-L1 agents were responsible for less severe adverse events (AEs), particularly, immunerelated AEs. These differences could be explained by their different specific properties. Considering possible differences between anti-PD1 and anti-PD-L1 agents could be clinically relevant for treatment tailoring and inspiring new investigational approaches.
Insights
Anti-programmed cell death protein 1 (anti-PD1) agents combined with chemotherapy show better outcomes for advanced non-small cell lung cancer (NSCLC) than anti-PD1-ligand (anti-PD-L1) agents. Anti-PD-L1 agents, however, cause fewer adverse events.
Area of Science:
- Immunotherapy
- Oncology
- Pharmacology
Background:
- Immune checkpoint inhibitors, including anti-PD1 and anti-PD-L1 agents, are crucial in non-small cell lung cancer (NSCLC) treatment.
- Understanding potential differences between anti-PD1 and anti-PD-L1 agents is vital for optimizing NSCLC therapy.
Purpose of the Study:
- To review indirect evidence comparing anti-PD1 and anti-PD-L1 agents in NSCLC.
- To highlight inter- and intra-class dissimilarities in efficacy and safety.
Main Methods:
- Systematic review of available indirect evidence.
- Comparative analysis of treatment outcomes and adverse events.
Main Results:
- Anti-PD1 agents plus chemotherapy demonstrated higher response rates and better outcomes in first-line treatment for advanced NSCLC (squamous and PD-L1 low) compared to anti-PD-L1 agents.
- Anti-PD-L1 agents were associated with a lower incidence of severe adverse events, particularly immune-related adverse events.
Conclusions:
- Intrinsic differences between anti-PD1 and anti-PD-L1 agents may influence clinical outcomes in NSCLC.
- Recognizing these differences is clinically relevant for personalized treatment strategies and future research in NSCLC immunotherapy.
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