Which treatment after first line therapy in NSCLC patients without genetic alterations in the era of immunotherapy?. (January 2022)

• Record Type: Journal Article
• Authors: Insa, Amelia; Martín-Martorell, Paloma; Di Liello, Raimondo; Fasano, Morena; Martini, Giulia; Napolitano, Stefania; Vicidomini, Giovanni; Cappabianca, Salvatore; Franco, Renato; Morgillo, Floriana; Della Corte, Carminia Maria
• Is Part Of: Critical reviews in oncology/hematology. Volume 169(2022)
• Publication Date: 2022-01
• Subjects: ICIs immune-checkpoint inhibitors -- PD-1 programmed cell death-1 -- PD-L1 programmed cell death ligand-1 -- NSCLC non-small cell lung cancer -- OS overall survival -- IHC immunohistochemistry -- CTLA-4 cytotoxic T-lymphocyte-associated antigen 4 -- HR hazard ratio -- PFS progression-free survival -- ORR objective response rate -- PS performance status -- ITT intention-to-treat -- VEGF vascular endothelial growth factor -- IO/IO combination immunotherapy -- TMB tumor mutational burden -- NPU Named Patient Use -- HCC hepatocellular carcinoma -- irAE immune-related adverse event -- MAPK mitogen-activated protein kinase -- IFNγ interferon-gamma -- Tregs regulatory T cells -- MDSCs myeloid derived suppressor cells -- RTK receptor tyrosine kinases -- NK natural killer -- TILs tumor infiltrating lymphocytes -- mAbs monoclonal antibodies -- EGFR epidermal growth factor receptor antibody -- ADCC Antibody-Dependent Cell-mediated Cytotoxicity -- DDR DNA damage responsive -- STING STimulator of INterferonGenes -- cGAS cyclic GMP-AMP synthase -- PARP poly-ADP-ribose polymerase; Immunotherapy -- Chemotherapy -- Second line therapy -- NSCLC -- ICI resistance; Oncology -- Periodicals; Hematology -- Periodicals; 616.994
• DOI: 10.1016/j.critrevonc.2021.103538
• Languages: English
• ISSNs: 1040-8428

Abstract

Graphical abstract: Highlights: Actually, the standard first line therapy for non-oncogene-addicted advanced NSCLC is immunotherapy with or without chemotherapy. Understanding immunotherapy resistance may help to define the best second line treatment strategy. Studying interconnections between innate and adaptive immunity that can help in identification and discovery of novel targets. Abstract: Cancer immunotherapy has produced an unprecedented durable response rate, thus shifting from traditional doublet chemotherapy to immunotherapy-based treatments with and without chemotherapy as the first line strategies for advanced non-small cell lung cancer patients without a molecular driver. However, the majority of patients do not benefit from the treatment or may relapse after a period of response. As few treatment options are available after failure of cancer immunotherapy, including the combination of chemotherapy and anti-angiogenic drugs, a better understanding of the mechanisms limiting cancer immunotherapy may be of help in the definition of the best second line. Whereas only retrospective data support an immunotherapy rechallenge approach, new combination strategies including immunotherapy and cell-signaling inhibitors or double immunotherapy represent the newest and most promising strategy to overcome primary or acquired resistance to first line immunotherapy.