Challenges of Immunotherapy in Stage IV Non-Small-Cell Lung Cancer

JCO Oncol Pract. 2021 Aug;17(8):465-471. doi: 10.1200/OP.20.00949. Epub 2021 Mar 15.

Abstract

Treatment for metastatic non-small-cell lung carcinoma has seen important advances in recent years with the introduction of targeted therapies and immunotherapy. Immune checkpoint inhibitors, which target the programmed death 1 receptor and programmed death ligand-1, alone or in combination with platinum-based chemotherapy, have become standard of care in the first-line setting for patients with advanced non-small-cell lung carcinoma without targetable driver mutations. However, several clinical questions have now since emerged. Physicians treating lung cancer lack guidance when treating patients who have a poor performance status, patients who are receiving corticosteroids, and those known for pre-existing autoimmune disorders. Furthermore, data are scarce on rechallenging a patient with immune checkpoint inhibitors after the occurrence of a significant immune-related adverse event. In this review, we aim to shed light on these topics.

Publication types

  • Review

MeSH terms

  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Humans
  • Immune Checkpoint Inhibitors
  • Immunologic Factors / therapeutic use
  • Immunotherapy
  • Lung Neoplasms* / therapy

Substances

  • Immune Checkpoint Inhibitors
  • Immunologic Factors