Immunological features of EGFR-mutant non-small cell lung cancer and clinical practice: a narrative review

Area of Science:

• Oncology
• Immunology
• Genetics

Background:

• Immune checkpoint inhibitors (ICIs) have revolutionized advanced driver-negative non-small cell lung cancer (NSCLC) treatment.
• Targeted therapy is the standard for advanced driver-positive NSCLC, particularly with epidermal growth factor receptor (EGFR) mutations.
• The role of immunotherapy in EGFR-mutant NSCLC is under investigation due to variable immunological features.

Purpose of the Study:

• To analyze the immunological characteristics of different EGFR mutations in NSCLC.
• To investigate the regulatory mechanisms influencing immunotherapy response in EGFR-mutant NSCLC.
• To review the current clinical application of immunotherapy in EGFR-mutant NSCLC patients.

Main Methods:

• Literature review and analysis of existing studies.
• Summary of immunological profiles associated with various EGFR mutations.
• Evaluation of clinical trial data on immunotherapy in EGFR-mutant NSCLC.

Main Results:

• EGFR mutations exhibit diverse immunological profiles, impacting treatment responses.
• Programmed cell death ligand 1 (PD-L1) expression, tumor mutation burden (TMB), and other factors vary significantly.
• Immunotherapy efficacy in EGFR-mutant NSCLC is complex and mutation-dependent.

Conclusions:

• Understanding the immunological landscape of EGFR-mutant NSCLC is crucial for optimizing immunotherapy.
• Further research is needed to define the precise role and application of ICIs in this patient population.
• Personalized treatment strategies integrating immunotherapy may improve outcomes for EGFR-mutant NSCLC.