Review of the recent clinical trials for PD-1/PD-L1 based lung cancer immunotherapy

ABSTRACT

Introduction

Lung cancer is known for its high mortality rate and prevalence in the world today. For decades, chemotherapy has been used as the main treatment for this cancer, but this has changed over time. Immune checkpoint inhibitors (ICIs) such as programmed death 1 and programmed death-ligand 1 (PD-1/PD-L1) blocking agents have been assessed in numerous clinical trials as single or combination therapy and have shown overall promising results. Nevertheless, various challenges have been encountered, which cast doubts over this method.

Areas covered

We provide an introduction to the mechanisms underlying the PD-1/PD-L1 pathway. Then, we discuss the latest results from the most leading-edge studies evaluating PD-1/PD-L1 inhibitors in different lines of lung cancer therapy (some of which have gained FDA approval), potential biomarkers, and major challenges of ICI therapy.

Expert opinion

Currently, the standard of care (SoC) for lung cancer consists mostly of chemotherapeutics. With further studies and ongoing trials evaluating novel ICI therapy, FDA has been approving specific ICI therapeutics, including PD-1/PD-L1 inhibitors, for particular types of lung cancer. However, for ICIs to play a key role in SoC, we need to overcome the major challenges of ICI therapy.

KEYWORDS:

• Combination therapy
• Immune checkpoint inhibitor
• Immunotherapy
• Lung cancer
• NSCLC

Article Highlights

• Cancer cells abuse the PD-1/PD-L1 pathway to avoid immune destruction.

• Immune checkpoint inhibitors (ICIs) block the PD-1/PD-L1 pathway and strengthen the anti-tumor activity.

• Studies comparing ICIs with conventional medications, have shown promising, yet challenging outcomes.

• To date, FDA has successfully approved several PD-1 and PD-L1 inhibitors to enter medical practice.

ICIs may cause complications ranging from a minor skin rash to an aggressive hyperprogressive disease.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.