The changing scenario of 1st line therapy in non-oncogene addicted NSCLCs in the era of immunotherapy

Publication date: Available online 18 June 2018
Source:Critical Reviews in Oncology/Hematology
Author(s): A Russo, T Franchina, GRR Ricciardi, G Toscano, S Schifano, G Lo Certo, A Battaglia, E Pantò, M Scaffidi Fonti, V Adamo
During the last two decades front-line treatment of metastatic Non Small Cell Lung Cancer (NSCLC) has profoundly changed moving from the old "one size fits all" concept to a "histology-based" approach and then, for a small subgroup of patients to a "molecularly-selected" one. The development of immune checkpoint inhibitors and the unprecedented results reported in 2^nd/3^rd line prompted the evaluation of these novel therapeutic agents in chemotherapy-naïve patients either alone or in combination with platinum-based chemotherapy. Several randomized trials are evaluating the impact of immune-checkpoint inhibitors in 1^st line and some of them have yet produced preliminary evidence of efficacy. However, still a long way to go and several questions are still unanswered, including proper patients selection, optimal sequential/combinatorial use of these agents, appropriate treatment duration, and finally the identification of predictive biomarkers. The aim of this paper is to provide a comprehensive overview on the growing role of immune checkpoint inhibitors in the upfront treatment of advanced non-oncogene addicted NSCLC either as single agent or in combination with other agents.



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