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Published on: August 11, 2017
[Research Progress in Immune Checkpoint Inhibitors Combination Therapy Applied to Non-small Cell Lung Cancer after
Jiamo Li1, Xingyu Yao1, Longjue Qiu1
1Department of Oncology, Zhongshan Hospital Affiliated to Dalian University, Dalian 116001, China.
Abstract:
With the development of precision medicine for lung cancer, targeted therapy has greatly improved the survival and prognosis of patients with advanced non-small cell lung cancer (NSCLC), but the occurrence of acquired drug resistance ultimately leads to patients with no targeted drugs available and no standard treatment options for this group of patients afterwards. The emergence of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of advanced NSCLC. However, due to the unique features of NSCLC with epidermal growth factor receptor (EGFR) mutation, such as immunosuppressive tumor microenvironment (TME), single ICIs treatment has limited clinical benefits in NSCLC patients with EGFR mutation, and the combination of ICIs with chemotherapy and/or targeted therapies is the trend. This review further discusses potential subpopulations with EGFR mutations that may benefit from ICIs treatment, and analyzes how decisions can be made in the era of combined immunotherapy to maximize the efficacy of ICIs treatment in EGFR mutation targeted therapy for NSCLC patients with drug resistance, with the aim of achieving individualized treatment.
Insights
Targeted therapy improves lung cancer survival, but drug resistance limits options. Combining immune checkpoint inhibitors with other treatments shows promise for EGFR-mutated non-small cell lung cancer patients with resistance.
Area of Science:
- Oncology
- Precision Medicine
- Immunotherapy
Background:
- Advanced non-small cell lung cancer (NSCLC) treatment has advanced with targeted therapies, but acquired drug resistance remains a significant challenge.
- Immune checkpoint inhibitors (ICIs) have transformed NSCLC treatment, yet their efficacy is limited in patients with epidermal growth factor receptor (EGFR) mutations due to an immunosuppressive tumor microenvironment (TME).
Approach:
- This review examines the potential benefits of ICIs in specific EGFR-mutated NSCLC subpopulations.
- It analyzes strategies for combining ICIs with chemotherapy and/or targeted therapies to overcome resistance.
- The focus is on maximizing treatment efficacy and achieving individualized care for NSCLC patients with drug resistance.
Key Points:
- Acquired resistance to targeted therapies necessitates alternative treatment strategies for advanced NSCLC.
- EGFR-mutated NSCLC presents unique challenges for single-agent ICI therapy.
- Combination therapies involving ICIs are emerging as a crucial trend for managing drug-resistant NSCLC.
Conclusions:
- Combined immunotherapy approaches are vital for improving outcomes in EGFR-mutated NSCLC.
- Identifying patient subpopulations who can benefit from ICIs is key to personalized treatment.
- Optimizing combination strategies will enhance the efficacy of targeted therapy and immunotherapy in resistant NSCLC.
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