Emerging immune checkpoint inhibitors for the treatment of non-small cell lung cancer

ABSTRACT

Introduction

Over the last decade, immune checkpoint inhibitors (ICIs) have impacted on the standard therapy for patients with non-small cell lung cancer (NSCLC). ICIs first showed efficacy in patients with advanced disease who had progressed after chemotherapy, later reaching the first-line therapy context alone, in combination with chemotherapy, and/or with dual-immunotherapy regimens.

Areas covered

Most of their benefit is, however, restricted to just 20% of patients due to primary or emergence of acquired resistance. In this review, we will describe the role of new emerging ICIs in the current panorama of NSCLC therapeutic approaches, not only in metastatic disease but also in locally advanced stage disease, with specific focus on those drugs under investigation in Phase 2/3 clinical trials.

Expert opinion

Several new ICIs are now under investigation to optimize NSCLC patient management; these are usually used in combination with other well-known agents, such as ‘traditional’ ICIs and chemotherapy, or with other newly developed drugs. Identification of better biomarkers will provide personalized treatment approaches to overcome patient-specific immune resistance.

KEYWORDS:

• Emerging drugs
• immune checkpoint inhibitor
• non-small cell lung cancer

Declaration of interest

L Paz-Ares is a board member of Genomica and Altum Sequencing; has been reimbursed for travel, accommodation, or expenses from Roche, AstraZeneca, AstraZeneca Spain, MSD, BMS, Lilly, and Pfizer; has received honoraria from Roche/Genentech, Lilly, Pfizer, Boehringer Ingelheim, BMS, MSD, AstraZeneca, Merck Serono, PharmaMar, Novartis, Celgene, Sysmex, Bayer, Amgen, Blueprint Medicines, and Incyte; and has received fees (immediate family member) from Novartis, Ipsen, Pfizer, Servier, Sanofi, Roche, Amgen, and Merck, all of which were outside the submitted work. J Baena has disclosed honoraria from BMS, Pfizer, AstraZeneca Spain, and consulting to AstraZeneca Spain. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

A reviewer on this manuscript has disclosed research funding to their institution from Merck, Abbvie, Takeda, Blueprint, Daiichi, and Cullinan. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.