Immune checkpoint inhibitors: Significant advancements in non–small cell lung cancer treatment

Abstract

Purpose This article explores the efficacy, toxicity, place in therapy, and considerations for use of recently approved immune checkpoint inhibitors (ICIs) in the treatment of non–small cell lung cancer (NSCLC). Summary Lung cancer is the leading cause of cancer mortality in the United States and is responsible for more cancer-related deaths than breast, prostate, and colorectal cancer combined. The landscape for lung cancer treatment is evolving with the approval of new and exciting novel therapies. Within the last decade numerous ICIs have been approved for use in the management of the most common subtype of lung cancer, NSCLC. The ICI agents currently approved by the Food and Drug Administration (FDA) for use in NSCLC include ipilimumab, pembrolizumab, nivolumab, durvalumab, and atezolizumab. These agents are approved for specific indications; therefore, they are not interchangeable. This review focuses on the landmark trials that led to each FDA-approved indication, as well as common toxicities seen with use of these agents. It also discusses the use of ICIs in special populations and unique considerations prior to initiation of treatment with these novel therapies in a patient with NSCLC. Conclusion ICIs can provide a breakthrough treatment option for the management of NSCLC and are rapidly being adopted into clinical practice. It is important to be familiar with appropriate selection of an ICI therapy option for each patient based on approved indication, unique considerations, and anticipated toxicities.

Cemiplimab combined with chemotherapy versus chemotherapy in advanced non-small cell lung cancer: an updated EMPOWER-Lung 3 trial-based cost-effectiveness analysis

“…The treatment of NSCLC has witnessed significant advancements in recent years, predominantly due to the availability of immune checkpoint inhibitors (ICIs) such as programmed cell death-1 (PD-1) and programmed death ligand 1 (PD-L1) inhibitors. 4 These inhibitors have revolutionized the management of NSCLC by modulating the body's immune response against cancer cells and have shown remarkable success in improving patient outcomes. The ability of these inhibitors to enhance the immune response selectively has promising implications for patients suffering from NSCLC and provides a viable alternative to traditional chemotherapy.…”

Immune checkpoint inhibitor-associated toxicity in advanced non-small cell lung cancer: An updated understanding of risk factors

“…Similarly, ipilimumab showed a better potential in extending PFS in NSCLC (4). Specifically, there are seven US Food and Drug Administration (FDA)-approved ICIs for the first-line or second-line treatment of NSCLC, including pembrolizumab, nivolumab, cemiplimab, atezolizumab, durvalumab, tremelimumab and ipilimumab (5)(6)(7).…”

Potentiating effect of reovirus on immune checkpoint inhibition in microsatellite stable colorectal cancer

“…Anti-PD-1 prevents PD-1 from engaging PD-L1, a ligand expressed by tumor cells. Currently, nivolumab, pembrolizumab (anti-PD-1) and ipilimumab (anti-CTLA4) are approved by the US-FDA to treat metastatic MSI CRC ( 5 ).…”