Successes and failures : what did we learn from recent first-line treatment immunotherapy trials in non-small cell lung cancer?
Cet article passe en revue les résultats contradictoires des essais récents de phase III évaluant des inhibiteurs de point de contrôle immunitaire en traitement de première ligne pour un cancer du poumon non à petites cellules
The immune checkpoint inhibitors have significantly modified the therapeutic landscape of advanced non-small cell lung cancer in second-line and, more recently, first-line settings. Because of the superior outcome with pembrolizumab as an upfront strategy, PD-L1 status should now be considered a new reflex biomarker for guiding first-line treatment in patients with advanced non-small cell lung cancer. Improved responses have also been reported with the combination of immune checkpoint inhibitors and chemotherapy as the first-line treatment; however, this strategy has not yet been validated by phase III trial data and its interplay with PD-L1 status still requires clarification.
In this manuscript we review the contradictory results of recent phase III trials with immune checkpoint inhibitors in the first-line setting, the potential reasons for discrepancies, and some of the remaining open questions related to the positioning of immune checkpoint inhibitors in the first-line setting of non-small cell lung cancer.
BMC Medicine , article en libre accès, 2016