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Review
. 2019 Mar;68(3):341-352.
doi: 10.1007/s00262-019-02310-2. Epub 2019 Feb 6.

Immunotherapy with checkpoint inhibitors in non-small cell lung cancer: insights from long-term survivors

Ernest Nadal  1   2 , Bartomeu Massuti  3 , Manuel Dómine  4 , Rosario García-Campelo  5 , Manuel Cobo  6 , Enriqueta Felip  7
Affiliations
Review

Immunotherapy with checkpoint inhibitors in non-small cell lung cancer: insights from long-term survivors

Ernest Nadal et al. Cancer Immunol Immunother. 2019 Mar.

Abstract

Immune checkpoint inhibitors (ICIs) targeting the programmed cell death-1 (PD-1)-programmed cell death ligand-1 (PD-L1) axis have shown promising results in non-small cell lung cancer (NSCLC) patients, some of them with persistent responses to these agents that form a population of long-term survivors. Despite the variable definition of PD-L1 positivity in tumors, an association between expression and response has been reasonably consistent in advanced NSCLC. In addition, the clinical efficacy of ICIs seems to be related to the genomic landscape of the tumor in terms of mutational burden and clonal neoantigens. Furthermore, increasing evidence shows that excessive activation of the immune response elicited by ICIs, leading to immune-related toxicities, might be associated with an improved response to immunotherapy. There are still many unanswered questions about the proper use of these agents to maximize their efficacy, which may be improved through combination with radiation, chemotherapy, targeted therapies, or other immune mediators, including dual checkpoint blockade. To search for clues for addressing these challenges, this review focused on the characteristics and clinical features of long-term NSCLC survivors and the potential biomarkers of response to ICIs.

Keywords: Biomarker; Immune checkpoint inhibitors; Immunotherapy; Long-term survival; Non-small cell lung cancer; PD-L1.

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Conflict of interest statement

Ernest Nadal has received honoraria for participating in advisory boards and speaking honorarium from Bristol-Myers Squibb, Merck Sharp & Dohme, Roche, Pfizer, Takeda, Boehringer Ingelheim and AstraZeneca. Bartomeu Massuti has received honoraria for participation in advisory boards and speaking from Amgen, AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Merck Serono, Merck Sharp & Dohme, Pfizer, and Roche. Manuel Dómine declares that he has no conflict of interest. Rosario García-Campelo has received honoraria for participation in advisory boards and speaking from AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Merck Sharp & Dohme, Novartis, Pfizer, Roche/Genentech, and Takeda. Manuel Cobo has received speaker honorarium from AstraZeneca, Bristol-Myers Squibb, Merck Sharp & Dohme, and Roche. Enriqueta Felip has received honoraria for participation in advisory boards and speaking from AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, GuardantHealth, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and Takeda.

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