Nivolumab and Pembrolizumab for Non-Small Cell Lung Cancer
Cet article passe en revue les perspectives offertes, pour les patients atteints d'un cancer avancé du poumon non à petites cellules, par les résultats récents d'essais cliniques ayant évalué des immunothérapies à base d'inhibiteurs de point de contrôle
The outcomes for patients with previously treated advanced stage non-small lung cancer (NSCLC) are very poor, with a modest benefit from chemotherapy over best supportive care. Immunotherapy offers a novel approach for the treatment of these patients, with two anti-programmed death 1 (PD-1) checkpoint inhibitors, nivolumab and pembrolizumab, recently approved by the US Food and Drug Administration based on large randomized clinical trials showing increased overall survival compared to standard second line docetaxel. Although only a small fraction of patients benefit from these drugs, the treatment is usually well tolerated and the responses are often durable, with an unprecedented number of survivors 3 years after starting the therapy. The next steps should be the identification of reliable predictors for benefit from immunotherapy with checkpoint inhibitors and the pursue of well-designed combination therapies. In this article, we review the rationale for the use of checkpoint inhibitors in NSCLC, the data from the phase 1 and randomized clinical trials, and the future directions.