The changing scenario of 1 st line therapy in non-oncogene addicted NSCLCs in the era of immunotherapy

• Published in: Critical reviews in oncology/hematology Vol. 130; p. 1
• Main Authors: Russo, A, Franchina, T, Ricciardi, G R R, Toscano, G, Schifano, S, Lo Certo, G, Battaglia, A, Pantò, E, Scaffidi Fonti, M, Adamo, V
• Format: Journal Article
• Language: English
• Published: Netherlands 01.10.2018
• Subjects: Pembrolizumab; First line; NSCLC; Durvalumab; Immunotherapy; Nivolumab; Avelumab; Atezolizumab

During the last two decades front-line treatment of metastatic Non Small Cell Lung Cancer (NSCLC) has profoundly changed moving from the old "one size fits all" concept to a "histology-based" approach and then, for a small subgroup of patients to a "molecularly-selected" one. The development of immune checkpoint inhibitors and the unprecedented results reported in 2 /3 line prompted the evaluation of these novel therapeutic agents in chemotherapy-naïve patients either alone or in combination with platinum-based chemotherapy. Several randomized trials are evaluating the impact of immune-checkpoint inhibitors in 1 line and some of them have yet produced preliminary evidence of efficacy. However, still a long way to go and several questions are still unanswered, including proper patients selection, optimal sequential/combinatorial use of these agents, appropriate treatment duration, and finally the identification of predictive biomarkers. The aim of this paper is to provide a comprehensive overview on the growing role of immune checkpoint inhibitors in the upfront treatment of advanced non-oncogene addicted NSCLC either as single agent or in combination with other agents.