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    Integrating immune checkpoint inhibitors and targeted therapies in the treatment of early stage non-small cell lung cancer: a narrative review

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    Authors
    Ortega-Franco, Ana
    Calvo, V.
    Franco, F.
    Provencio, M.
    Califano, Raffaele
    Affiliation
    Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK.
    Issue Date
    2020
    
    Metadata
    Show full item record
    Abstract
    Prognosis of early stage non-small cell lung cancer (eNSCLC) is poor even when treated radically with surgery and (neo)adjuvant chemotherapy (Cht). The discovery of tyrosine kinase inhibitors (TKIs) for oncogene addicted NSCLC and immune checkpoint inhibitors (ICIs) have revolutionised the therapeutic paradigm and improved survival of advanced NSCLC. The unprecedented impact of these drugs has shifted the focus of investigation to early stage disease aiming at improving cure. In this context, several single arm phase II studies evaluating neoadjuvant ICI alone or in combination with platinum-based Cht have shown encouraging rates of pathological response which have spurred several ongoing randomized trials with (neo)adjuvant ICI. More recently, ADAURA study evaluating adjuvant osimertinib demonstrated a profound reduction of the risk of recurrence in patients with stage I (>4 cm)-IIIA eNSCLC harbouring EGFR sensitizing mutations. ICIs and TKIs represent a true revolution in the treatment of eNSCLC call to challenge the current standard of care. However, questions regarding drug resistance, recurrence patterns, biomarker identification, optimal treatment duration and sequencing need be answered to effectively integrate new drugs in the rapidly evolving therapeutic landscape of NSCLC. In this review we critically review new developments and future perspectives of TKIs and ICI as (neo)adjuvant strategies for eNSCLC.
    Citation
    Ortega-Franco A, Calvo V, Franco F, Provencio M, Califano R. Integrating immune checkpoint inhibitors and targeted therapies in the treatment of early stage non-small cell lung cancer: a narrative review. Transl Lung Cancer Res. 2020;9(6):2656-73.
    Journal
    Translational Lung Cancer Research
    URI
    http://hdl.handle.net/10541/623789
    DOI
    10.21037/tlcr-20-546
    PubMed ID
    33489825
    Additional Links
    https://dx.doi.org/10.21037/tlcr-20-546
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.21037/tlcr-20-546
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