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Immune checkpoint inhibitors in EGFR-mutant non-small cell lung cancer: A systematic review
Ilaria Attili1, Antonio Passaro1, Carla Corvaja1
1Division of Thoracic Oncology, European Institute of Oncology IRCCS, Via G. Ripamonti 435, 20141 Milan, Italy.
Background:
Since their first introduction in clinical practice, immune checkpoint inhibitors showed limited benefit in patients with NSCLC harboring EGFR mutations. With the rationale of increasing immune activation, combinatorial ICI strategies have been evaluated also in this subgroup of patients.
Methods:
We performed a systematic review on efficacy of ICI-based strategies in EGFR-mutant NSCLC according to most updated evidence.
Results:
Overall, ICI monotherapy and ICI plus chemotherapy confirm to be ineffective in EGFR-mutant NSCLC, whereas the combination of ICI with antiangiogenic and chemotherapy showed promising results. Limited data are available with alternative ICI combination strategies, driven by strong biological rationale of modulating the tumor immune microenvironment.
Conclusions:
To date, the available evidence do not support the use of ICI in patients with NSCLC harboring EGFR mutations. Clinical trials are ongoing to define which is the best timing and exploring novel combinations with ICI in this specific disease.
Insights
Immune checkpoint inhibitors (ICIs) show limited benefit for EGFR-mutant non-small cell lung cancer (NSCLC). Combinations with antiangiogenics and chemotherapy show promise, but further trials are needed.
Area of Science:
- Oncology
- Immunotherapy
- Genomics
Background:
- Immune checkpoint inhibitors (ICIs) have demonstrated limited efficacy in patients with non-small cell lung cancer (NSCLC) who harbor epidermal growth factor receptor (EGFR) mutations.
- Combinatorial ICI strategies are being explored to enhance immune activation in this patient subgroup.
Purpose of the Study:
- To systematically review the efficacy of ICI-based strategies in EGFR-mutant NSCLC based on the latest evidence.
- To evaluate the potential of various ICI combination therapies in this specific cancer type.
Main Methods:
- Systematic review of published literature.
- Analysis of efficacy data for ICI monotherapy, ICI plus chemotherapy, and ICI combined with antiangiogenic agents and chemotherapy.
Main Results:
- ICI monotherapy and ICI plus chemotherapy are ineffective in EGFR-mutant NSCLC.
- Combining ICIs with antiangiogenic agents and chemotherapy demonstrates promising results.
- Limited data exist for alternative ICI combinations targeting the tumor immune microenvironment.
Conclusions:
- Current evidence does not support the use of ICIs in NSCLC patients with EGFR mutations.
- Ongoing clinical trials aim to determine optimal timing and novel ICI combinations for EGFR-mutant NSCLC.
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