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

Détails

ID Serval
serval:BIB_2C9FA7FE4F90
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Immunotherapy in unresectable stage III non-small-cell lung cancer: state of the art and novel therapeutic approaches.
Périodique
Annals of oncology
Auteur⸱e⸱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
Statut éditorial
Publié
Date de publication
09/2022
Peer-reviewed
Oui
Volume
33
Numéro
9
Pages
893-908
Langue
anglais
Notes
Publication types: Journal Article ; Review ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
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.
Mots-clé
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
Web of science
Open Access
Oui
Création de la notice
12/07/2022 10:31
Dernière modification de la notice
30/03/2023 5:53
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