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Comment
. 2018 Feb 16;16(1):24.
doi: 10.1186/s12916-018-1011-0.

Second-line treatment for advanced NSCLC without actionable mutations: is immunotherapy the 'panacea' for all patients?

Alessandro Morabito  1
Affiliations
Comment

Second-line treatment for advanced NSCLC without actionable mutations: is immunotherapy the 'panacea' for all patients?

Alessandro Morabito. BMC Med. .

Abstract

The therapeutic approach for the second-line treatment of patients with advanced non-small cell lung cancer (NSCLC) without actionable mutations has been revolutionized by the recent approval of new effective drugs with various mechanisms of action, including nintedanib, ramucirumab, nivolumab, pembrolizumab, atezolizumab, and afatinib. The recent network meta-analysis of Créquit et al. (BMC Medicine, 15:193, 2017) compared the effectiveness and tolerability of the second-line treatments for advanced NSCLC with wild-type or unknown status for EGFR. The authors found that immunotherapy might be more efficacious than the currently recommended treatments. However, their meta-analysis does not take into account the role of predictive biomarkers - this is indeed a crucial point in the decision-making process considering that only a fraction of advanced NSCLC patients might derive a long-term benefit from second-line immunotherapy. The identification of molecular biomarkers that can predict a response to immune checkpoints, angiogenesis, and EGFR inhibitors remains an important goal of clinical research in order to maximize the benefit of these agents and to aid clinicians in the decision-making process.Please see related article: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0954-x.

Keywords: Afatinib; Atezolizumab; Docetaxel; Erlotinib; NSCLC; Nintedanib; Nivolumab; Pembrolizumab; Pemetrexed; Ramucirumab; Second-line therapy.

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Conflict of interest statement

Competing interests

The author has participated in speakers bureaus from Pfizer, AstraZeneca, Roche, Boehringer, Bristol Mayer Squibb, Merck Sharp, and Dohme.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Therapeutic scenario for patients with advanced non-squamous ‘undruggable’ NSCLC (EGFR wild type, ALK and ROS1 non-rearranged, PD-L1 < 50%)
Fig. 2
Fig. 2
Therapeutic scenario for patients with advanced squamous ‘undruggable’ NSCLC (PD-L1 < 50%)
See this image and copyright information in PMC

Comment on

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