What is the optimal duration, dose and frequency for anti-PD1 therapy of non-small cell lung cancer?

• Published in: Therapeutic Advances in Medical Oncology Vol. 15; p. 17588359231210271
• Main Authors: Kuah, Chii Yang, Monfries, Robert, Quartagno, Matteo, Seckl, Michael J., Ghorani, Ehsan
• Format: Book Review Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2023; Sage Publications Ltd; SAGE Publishing
• Subjects: Immune checkpoint inhibitors; Immunosuppressive agents; Lung cancer; Malignancy; Non-small cell lung carcinoma; PD-1 protein; Pembrolizumab; Quality of life; Review; Small cell lung carcinoma; Toxicity; non-small cell lung cancer; duration; dose; overtreatment; immunotherapy; checkpoint inhibitor
• ISSN: 1758-8359; 1758-8340; 1758-8359
• DOI: 10.1177/17588359231210271

Over the past decade, immune checkpoint inhibitors (ICIs) have transformed the management of multiple malignancies including lung cancer. However, the optimal use of these agents in terms of duration, dose and administration frequency remains unknown. Focusing on anti-PD1 agents nivolumab and pembrolizumab in the context of non-small cell lung cancer, we argue that several lines of evidence suggest current administration regimens of these drugs may result in overtreatment with potentially important implications for cost, quality of life and toxicity. This review summarizes evidence for the scope to optimize anti-PD1 regimens, the limitations of existing data and potential approaches to solve these problems including with a novel multi-arm clinical trial design implemented in the recently opened REFINE-Lung study.