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Vol.61 No.2 contents | Japanese/English |
 | Full Text of PDF (276K) Article in Japanese |
- Invited Review Article -
First-line Immunotherapy for Advanced Non-small-cell Lung Cancer
Haruko Daga11Department of Medical Oncology, Osaka City General Hospital, Japan
Until the advent of immune checkpoint inhibitors, first-line treatment of patients with advanced non-small-cell lung cancer (NSCLC) without an EGFR/ALK alteration was platinum-based chemotherapy. The introduction of immune checkpoint inhibitors has altered the treatment paradigm for patients with advanced NSCLC. A phase III trial comparing pembrolizumab with platinum-based chemotherapy was conducted in EGFR/ALK-negative advanced NSCLC patients with a tumor proportion score (TPS) for programmed cell death-ligand 1 (PD-L1) of ≥50%. Pembrolizumab monotherapy significantly improved the progression-free survival (PFS) and overall survival (OS) with tolerability. In addition, several phase III studies showed a higher efficacy of combination treatment with an immune checkpoint inhibitor than platinum-based chemotherapy alone in advanced NSCLC. Immunotherapy is an important treatment modality for driver oncogene-negative NSCLC. It is important to know which regimen is the most useful for each patient, but such details are still unclear, and no biomarkers have yet been established. Therefore, it is necessary to choose a treatment regimen while considering the patient background, PD-L1 expression, characteristics and toxicity profile of each regimen in clinical practice. Establishing predictive markers of long-term clinical benefit with immune checkpoint inhibitor treatment is an important issue.
key words: Non-small-cell lung cancer (NSCLC), Immune checkpoint inhibitor, Programmed cell death-ligand 1 (PD-L1), Combination immunotherapy, Immune related adverse event (irAE)
JJLC 61 (2): 88-94, 2021
