ABSTRACT

Introduction: One of the latest breakthroughs in the treatment of advanced Non Small Cell Lung Cancer (NSCLC) is represented by PD-1/PD-L1-targeting Immune Checkpoint Inhibitors (ICIs). However, only a limited subset of advanced NSCLC patients can receive first-line ICI monotherapy (advanced NSCLC patients without driver mutations and with a PD-L1 expression ≥50% or ≥1%) and naïve ICI-respondent patients represent an even more limited subgroup of patients, which eventually experience progression of disease after approximately 7–11 months. Therefore, different strategies are being evaluated to obtain a higher response rate and a more durable clinical response in this setting. A very encouraging one is represented by ICI-combination therapies, i.e. the use of an ICI combined to cytotoxic chemotherapy and/or another immunotherapeutic agent.

Areas covered: This paper aims to assess currently available data from trials evaluating nivolumab-based first-line combination therapies.

Expert opinion: Nivolumab-based combinations regimens will represent one of the standard treatments for naïve advanced NSCLC patients in a near future. However, in order to fully exploit these combination therapies, additional studies assessing potential predictive and/or prognostic biomarkers are required to better clarify which patients are more likely to benefit from these regimens, alongside with studies investigating safer and more durable second-line treatments.

摘要

介绍：治疗晚期非小细胞肺癌 (NSCLC) 的最新突破之一是靶向 PD-1/PD-L1 的免疫检查点抑制剂 (ICI)。然而，只有有限的晚期 NSCLC 患者可以接受一线 ICI 单药治疗（没有驱动突变且 PD-L1 表达≥50% 或 ≥1% 的晚期 NSCLC 患者），而未接受 ICI 应答的患者代表了更有限的患者亚组，最终在大约 7-11 个月后出现疾病进展。因此，正在评估不同的策略，以在这种情况下获得更高的反应率和更持久的临床反应。一个非常令人鼓舞的代表是 ICI 组合疗法，即使用 ICI 与细胞毒性化学疗法和/或另一种免疫治疗剂相结合。

涵盖的领域：本文旨在评估来自评估基于纳武单抗的一线联合疗法的试验的当前可用数据。

专家意见：在不久的将来，基于纳武单抗的联合方案将成为初治晚期 NSCLC 患者的标准治疗方法之一。然而，为了充分利用这些联合疗法，还需要评估潜在的预测和/或预后生物标志物的额外研究，以更好地阐明哪些患者更有可能从这些方案中受益，同时研究更安全、更持久的二线治疗。