Abstract
The treatment paradigm for lung cancer has been transformed in recent years by the
use of immunotherapy, specifically, immune checkpoint antibodies (mAb), which are
agents designed to reinvigorate an immune-mediated anticancer response by releasing
the effects of tumor-mediated immunosuppression. Late-phase clinical trials of these
agents in patients with advanced lung cancers have translated into improved clinical
outcomes compared with standard-of-care chemotherapy for the treatment of metastatic
non-small cell lung cancer, and have resulted in FDA approvals for two immune checkpoint
mAbs in the second-line setting. In addition, promising results have been seen in
early-phase clinical studies in small cell lung cancer (SCLC) and for immune checkpoint
combinations in NSCLC thus far. While the efficacy of these agents is exciting, they
have also been associated with a unique profile of immune-mediated toxicity that is
distinct from classic cytotoxic therapies. As these agents move into the lung cancer
clinic, we must seek to maximize the therapeutic potential of this class of agents
through optimization of patient selection, improved response assessments, and exploring
rational combinations of immune checkpoint mAbs with other potentially synergistic
therapies, to improve response rates and extend the “tail on the curve.”
Keywords
immunotherapy - immune checkpoint antibody - anti-CTLA-4 - anti-PD-1 - anti-PD-L1
- non-small cell lung cancer - small cell lung cancer - lung cancer
