Immunotherapy in unresectable stage III non-small-cell lung cancer: state of the art and novel therapeutic approaches.

Details

Serval ID
serval:BIB_2C9FA7FE4F90
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Immunotherapy in unresectable stage III non-small-cell lung cancer: state of the art and novel therapeutic approaches.
Journal
Annals of oncology
Author(s)
Cortiula F., Reymen B., Peters S., Van Mol P., Wauters E., Vansteenkiste J., De Ruysscher D., Hendriks LEL
ISSN
1569-8041 (Electronic)
ISSN-L
0923-7534
Publication state
Published
Issued date
09/2022
Peer-reviewed
Oui
Volume
33
Number
9
Pages
893-908
Language
english
Notes
Publication types: Journal Article ; Review ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
The standard of care for patients with stage III non-small-cell lung cancer (NSCLC) is concurrent chemoradiotherapy (CCRT) followed by 1 year of adjuvant durvalumab. Despite the survival benefit granted by immunotherapy in this setting, only 1/3 of patients are alive and disease free at 5 years. Novel treatment strategies are under development to improve patient outcomes in this setting: different anti-programmed cell death protein 1/programmed death-ligand 1 [anti-PD-(L)1] antibodies after CCRT, consolidation immunotherapy after sequential chemoradiotherapy, induction immunotherapy before CCRT and immunotherapy concurrent with CCRT and/or sequential chemoradiotherapy. Cross-trial comparison is particularly challenging in this setting due to the different timing of immunotherapy delivery and different patients' inclusion and exclusion criteria. In this review, we present the results of clinical trials investigating immune therapy in unresectable stage III NSCLC and discuss in-depth their biological rationale, their pitfalls and potential benefits. Particular emphasis is placed on the potential mechanisms of synergism between chemotherapy, radiation therapy and different monoclonal antibodies, and how this affects the tumor immune microenvironment. The designs and questions tackled by ongoing clinical trials are also discussed. Last, we address open questions and unmet clinical needs, such as the necessity for predictive biomarkers (e.g. radiomics and circulating tumor DNA). Identifying distinct subsets of patients to tailor anticancer treatment is a priority, especially in a heterogeneous disease such as stage III NSCLC.
Keywords
Carcinoma, Non-Small-Cell Lung/pathology, Chemoradiotherapy/methods, Humans, Immunologic Factors, Immunotherapy/methods, Lung Neoplasms/pathology, Neoplasm Staging, Tumor Microenvironment, biomarkers, circulating tumor DNA, immunotherapy, locally advanced NSCLC, radiomics, stage III NSCLC
Pubmed
Open Access
Yes
Create date
12/07/2022 10:31
Last modification date
11/11/2022 6:39
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