Nivolumab plus ipilimumab for the first-line treatment of metastatic NSCLC

Expert Rev Anticancer Ther. 2021 Jul;21(7):705-713. doi: 10.1080/14737140.2021.1903322. Epub 2021 Mar 28.

Abstract

Introduction: In the last decade, immune checkpoint inhibitors have revolutionized the treatment of several malignancies including non-small cell lung cancer (NSCLC). The inhibition of cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and the programmed death receptor 1 (PD-1) pathways leads to an activation of the immune response against tumor cells. Thanks to a synergistic effect, the combination of the checkpoint inhibitors nivolumab and ipilimumab has the potential to improve outcomes of NSCLC patients.

Areas covered: We provide an overview of clinical trials evaluating the combination of nivolumab and ipilimumab in the first-line treatment of advanced NSCLC patients.

Expert opinion: The combination of nivolumab and ipilimumab, alone or with a few cycles of chemotherapy, was demonstrated to be a valid option for first-line treatment of metastatic NSCLC patients without EGFR mutation and ALK rearrangement. However, a better understanding of patients who can benefit from this approach is required.

Keywords: CTLA-4; ipilimumab; nivolumab; nsclc; pd-1; pd-l1.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Carcinoma, Non-Small-Cell Lung* / pathology
  • Clinical Trials as Topic
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use
  • Ipilimumab* / therapeutic use
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / pathology
  • Nivolumab* / therapeutic use

Substances

  • Immune Checkpoint Inhibitors
  • Ipilimumab
  • Nivolumab