Bone Metastasis and Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer (NSCLC): Microenvironment and Possible Clinical Implications

Patients with non-small cell lung cancer (NSCLC) develop bone metastasis (BoM) in more than 50% of cases during the course of the disease. This metastatic site can lead to the development of skeletal related events (SREs), such as severe pain, pathological fractures, spinal compression, and hypercal...

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Published inInternational journal of molecular sciences Vol. 23; no. 12; p. 6832
Main Authors Del Conte, Alessandro, De Carlo, Elisa, Bertoli, Elisa, Stanzione, Brigida, Revelant, Alberto, Bertola, Manuela, Spina, Michele, Bearz, Alessandra
Format Journal Article
LanguageEnglish
Published Basel MDPI AG 20.06.2022
MDPI
Subjects
Bone cancer
Bone marrow
bone metastasis
Bone tumors
Cancer therapies
Chemotherapy
Compression
Cytokines
FDA approval
Fractures
Hypercalcemia
Immune checkpoint inhibitors
Immune system
Immunotherapy
Inhibitors
Ligands
Lung cancer
Lymphatic system
Lymphocytes
Medical prognosis
Metastases
Metastasis
microenvironment
Microenvironments
Mutation
non-small cell lung cancer (NSCLC)
Non-small cell lung carcinoma
Patients
Quality of life
Review
Tumors
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Summary:Patients with non-small cell lung cancer (NSCLC) develop bone metastasis (BoM) in more than 50% of cases during the course of the disease. This metastatic site can lead to the development of skeletal related events (SREs), such as severe pain, pathological fractures, spinal compression, and hypercalcemia, which reduce the patient’s quality of life. Recently, the treatment of advanced NSCLC has radically changed due to the advent of immunotherapy. Immune checkpoint inhibitors (ICI) alone or in combination with chemotherapy have become the main therapeutic strategy for advanced or metastatic NSCLC without driver gene mutations. Since survival has increased, it has become even more important to treat bone metastasis to prevent SRE. We know that the presence of bone metastasis is a negative prognostic factor. The lower efficacy of immunotherapy treatments in BoM+ patients could be induced by the presence of a particular immunosuppressive tumor and bone microenvironment. This article reviews the most important pre-clinical and clinical scientific evidence on the reasons for this lower sensitivity to immunotherapy and the need to combine bone target therapies (BTT) with immunotherapy to improve patient outcome.
Bibliography:ObjectType-Article-2
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ISSN:1422-0067
1661-6596
1422-0067
DOI:10.3390/ijms23126832