Abstrait

Current state of immunotherapy: chipping away at the tip of the iceberg.

Nisha Mohindra

The advent of immunotherapy has vastly altered the treatment landscape of many malignancies, with lung cancer being one of the biggest benefactors. We now have approved immunotherapy agents for both first- and second-line treatment of metastatic non-small cell lung cancer (NSCLC) as well as promising results from immunotherapy agents in extensivestage small cell lung cancer (SCLC)[1-6]. Three check point inhibitors—nivolumab and pembrolizumab (monoclonal antibody against programmed death 1 (PD-1)), and atezolizumab (monoclonal antibody against programmed death ligand 1 (PDL-1))—have now demonstrated improved overall survival and a favorable toxicity profile when compared to chemotherapy, leading to their respective Federal Drug Administration (FDA) approvals[2-6].There is now evidence that immunotherapy may also have efficacy in earlier stages of disease. The PACIFIC trial demonstrated a significant improvement in progression-free survival with use of durvalumab (anti-PDL1 monoclonal antibody) as consolidation therapy compared to placebo after definitive chemoradiation for inoperable stage III NSCLC. Mature overall survival data are awaited[7].