Ahead of print
Review paper
Published online: 2023-12-18

open access

Page views 151
Article views/downloads 30
Get Citation

Connect on Social Media

Connect on Social Media

Immunochemotherapy in patients with non-squamous lung cancer

Adam Płużański1, Aleksandra Piórek1

Abstract

Immunochemotherapy is one of the main treatment options in patients with non-squamous non-small-cell lung cancer without molecular targeted abnormalities. In Poland, immunotherapy given concurrently with chemotherapy is available in patients with programmed death ligand 1 (PD-L1) expression below 50%. Pembrolizumab plus chemotherapy and nivolumab with ipilimumab with 2 cycles of chemotherapy are more efficient than chemotherapy alone with longer progression-free survival (PFS) and overall survival (OS). Other immunochemotherapy regimens including atezolizumab, durvalumab, tremelimumab, or cemiplimab are not used in daily practice in Poland. Benefits observed with immunochemotherapy are limited to patients in Eastern Cooperative Oncology Group (ECOG) performance status of 0–1 and without contraindications to immune checkpoint inhibitors and cytotoxic agents. 

Article available in PDF format

View PDF Download PDF file

References

  1. Zitvogel L, Galluzzi L, Smyth MJ, et al. Mechanism of action of conventional and targeted anticancer therapies: reinstating immunosurveillance. Immunity. 2013; 39(1): 74–88.
  2. Galluzzi L, Buqué A, Kepp O, et al. Immunological Effects of Conventional Chemotherapy and Targeted Anticancer Agents. Cancer Cell. 2015; 28(6): 690–714.
  3. Peng J, Hamanishi J, Matsumura N, et al. Chemotherapy Induces Programmed Cell Death-Ligand 1 Overexpression via the Nuclear Factor-κB to Foster an Immunosuppressive Tumor Microenvironment in Ovarian Cancer. Cancer Res. 2015; 75(23): 5034–5045.
  4. Gadgeel S, Stevenson J, Langer C, et al. Pembrolizumab and platinum-based chemotherapy as first-line therapy for advanced non–small-cell lung cancer: Phase 1 cohorts from the KEYNOTE-021 study. Lung Cancer. 2018; 125: 273–281.
  5. Langer CJ, Gadgeel SM, Borghaei H, et al. KEYNOTE-021 investigators. Carboplatin and pemetrexed with or without pembrolizumab for advanced, non-squamous non-small-cell lung cancer: a randomised, phase 2 cohort of the open-label KEYNOTE-021 study. Lancet Oncol. 2016; 17(11): 1497–1508.
  6. Gandhi L, Rodríguez-Abreu D, Gadgeel S, et al. KEYNOTE-189 Investigators. Pembrolizumab plus Chemotherapy in Metastatic Non-Small-Cell Lung Cancer. N Engl J Med. 2018; 378(22): 2078–2092.
  7. Rodríguez-Abreu D, Powell SF, Hochmair MJ, et al. Pemetrexed plus platinum with or without pembrolizumab in patients with previously untreated metastatic nonsquamous NSCLC: protocol-specified final analysis from KEYNOTE-189. Ann Oncol. 2021; 32(7): 881–895.
  8. Garassino MC, Gadgeel S, Speranza G, et al. Pembrolizumab Plus Pemetrexed and Platinum in Nonsquamous Non-Small-Cell Lung Cancer: 5-Year Outcomes From the Phase 3 KEYNOTE-189 Study. J Clin Oncol. 2023; 41(11): 1992–1998.
  9. Socinski MA, Nishio M, Jotte RM, et al. IMpower150 Final Overall Survival Analyses for Atezolizumab Plus Bevacizumab and Chemotherapy in First-Line Metastatic Nonsquamous NSCLC. J Thorac Oncol. 2021; 16(11): 1909–1924.
  10. Nogami N, Barlesi F, Socinski M, et al. IMpower150 Final Exploratory Analyses for Atezolizumab Plus Bevacizumab and Chemotherapy in Key NSCLC Patient Subgroups With EGFR Mutations or Metastases in the Liver or Brain. J Thorac Oncol. 2022; 17(2): 309–323.
  11. Gogishvili M, Melkadze T, Makharadze T, et al. Cemiplimab plus chemotherapy versus chemotherapy alone in non-small cell lung cancer: a randomized, controlled, double-blind phase 3 trial. Nat Med. 2022; 28(11): 2374–2380.
  12. Makharadze T, Gogishvili M, Melkadze T, et al. Cemiplimab Plus Chemotherapy Versus Chemotherapy Alone in Advanced NSCLC: 2-Year Follow-Up From the Phase 3 EMPOWER-Lung 3 Part 2 Trial. J Thorac Oncol. 2023; 18(6): 755–768.
  13. Paz-Ares L, Ciuleanu TE, Cobo M, et al. First-line nivolumab plus ipilimumab combined with two cycles of chemotherapy in patients with non-small-cell lung cancer (CheckMate 9LA): an international, randomised, open-label, phase 3 trial. Lancet Oncol. 2021; 22(2): 198–211.
  14. Reck M, Ciuleanu TE, Cobo M, et al. First-line nivolumab plus ipilimumab with two cycles of chemotherapy versus chemotherapy alone (four cycles) in advanced non-small-cell lung cancer: CheckMate 9LA 2-year update. ESMO Open. 2021; 6(5): 100273.
  15. Johnson ML, Cho BC, Luft A, et al. POSEIDON investigators. Durvalumab With or Without Tremelimumab in Combination With Chemotherapy as First-Line Therapy for Metastatic Non-Small-Cell Lung Cancer: The Phase III POSEIDON Study. J Clin Oncol. 2023; 41(6): 1213–1227.