Long-term survival of patients with advanced non-small cell lung cancer treated using immune checkpoint inhibitors

Area of Science:

• Oncology
• Immunotherapy
• Pulmonology

Background:

• Lung cancer is a leading cause of cancer mortality globally, often presenting with metastasis.
• Advanced non-small cell lung cancer (NSCLC) lacking targetable mutations presents a therapeutic challenge.
• Immune checkpoint inhibitors (ICIs) targeting PD-1/PD-L1 and CTLA-4 have shown superior efficacy over standard treatments in phase III trials.

Purpose of the Study:

• To review and summarize long-term survival data for patients with advanced NSCLC without driver mutations treated with first-line ICIs.
• To consolidate evidence on the durability of response and long-lasting effects of ICI therapy in this patient population.

Main Methods:

• Systematic review of phase III clinical trials evaluating first-line immune checkpoint inhibitors (ICIs) in advanced non-small cell lung cancer (NSCLC) patients without targetable genomic driver mutations.
• Analysis of reported long-term survival outcomes and durability of response from the selected trials.

Main Results:

• First-line ICI therapy, including PD-1 or PD-L1 inhibitors, has demonstrated unprecedented prolonged survival in advanced NSCLC patients without driver mutations.
• Long-lasting treatment effects have been observed, with benefits persisting even after discontinuation of ICI therapy.
• The majority of patients with advanced NSCLC and no driver mutation are now treated with ICIs in the first-line setting to achieve long-term responses.

Conclusions:

• First-line immune checkpoint inhibitors represent a significant advancement in the management of advanced NSCLC without driver mutations, offering durable long-term survival.
• The review highlights the critical need for comprehensive data on long-term outcomes to guide optimal treatment strategies in this patient group.