Immune checkpoint inhibitors in non-small cell lung cancer - towards daily practice

Abstract

Immunotherapy with immune checkpoint inhibitors (ICIs) revolutionized therapy of solid tumors, among them- lung cancer. PD-1, PD-L1 blockers have been shown to improve overall survival in advanced, metastatic non-small cell lung cancer. In individual patients, 3-5-year survival has been achieved. Nivolumab, pembrolizumab, atezolizumab are approved in lung cancer treatment. Practical observations in reallife show that the results are comparable with those achieved in clinical trials. The effects of ICIs depend on the patient performance status; age, sex, histology; the presence of brain metastases have not modified treatment results. ICIs therapy is safe and well tolerated; immune related adverse events are observed. Pneumonitis may be a serious and fatal complication, but glucocorticoids are usually curative. For proper patients selection for ICIs treatment, the detection of PD-L1 expression on cancer cells is used. The so-called "hot" tumors with high expression of PD-L1 and abundant infiltration by cytotoxic cells seem to better respond to treatment than "cold" tumors.

Keywords: PD-1; PD-L1; adverse events; immunoscoring; immunotherapy; lung cancer.