Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Aug 18:11:704336.
doi: 10.3389/fonc.2021.704336. eCollection 2021.

Current Status of Immune Checkpoint Inhibitor Immunotherapy for Lung Cancer

Wei Xiong  1 , Yunfeng Zhao  2 , He Du  3 , Xuejun Guo  1
Affiliations
Review

Current Status of Immune Checkpoint Inhibitor Immunotherapy for Lung Cancer

Wei Xiong et al. Front Oncol. .

Abstract

Immunotherapy is a major breakthrough in the treatment of cancer in recent years. Immune checkpoint inhibitors (ICIs) including programmed death-ligand 1 (PD-L1)/programmed death-1 (PD-1) and cytotoxic T-lymphocyte antigen-4 (CTLA-4) have been used for different histologic types of cancer including primary lung cancer that represents the most common and fatal cancer globally. Among ICI immunotherapy agents, atezolizumab, durvalumab, ipilimumab, nivolumab, and pembrolizumab are currently used as standard-of-care (SOC) treatment for metastatic or earlier stages of lung cancer. Major issues of ICI immunotherapy in lung cancer comprise the use of immune biomarkers prior to ICI therapy, selection of ICI agents, combination of ICIs/chemotherapy, combination of ICIs/radiotherapy, sequence of tyrosine kinase inhibitor (TKI) targeted therapy and ICI immunotherapy, sequence of chemotherapy and ICI immunotherapy, treatment duration of ICI regimen and ICI therapy for different histopathology, stage, PD-L1, and performance status. Based on the contemporary major clinical trials and authoritative guidelines, the objective of this review is to present an overview of the current status of ICI immunotherapy in lung cancer.

Keywords: current status; immune checkpoint inhibitors; immunotherapy; lung cancer; programmed death-ligand 1.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
First-Line ICI Immunotherapy for Lung Cancer. In the first-line ICI immunotherapy of lung cancer, for metastatic NSCLC patients with PD-L1 ≥50% without TKI mutation, pembrolizumab monotherapy is preferred. For metastatic NSCLC patients with PD-L1 1%–49% who are intolerable or unacceptable to chemotherapy, pembrolizumab monotherapy may be considered. Regardless of PD-L1 level, for metastatic non-squamous NSCLC patients without TKI mutation, pembrolizumab/chemotherapy is preferred or ABCP regimen may be considered. Regardless of PD-L1 level, for metastatic squamous NSCLC patients, carboplatin/paclitaxel/pembrolizumab regimen is preferred. Regardless of PD-L1 level, for metastatic SCLC patients, atezolizumab or durvalumab/EP chemotherapy is preferred. ICIs, immune checkpoint inhibitors; NSCLC, non-small cell lung cancer; SCLC, small cell lung cancer; PD-L1, programmed death-ligand 1; TKI, tyrosine kinase inhibitor; ABCP, atezolizumab/bevacizumab/carboplatin/paclitaxel; EP, etoposide/platinum.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Tumeh PC, Harview CL, Yearley JH, Shintaku IP, Taylor EJ, Robert L, et al. . PD-1 Blockade Induces Responses by Inhibiting Adaptive Immune Resistance. Nature (2014) 515:568–71. 10.1038/nature13954 - DOI - PMC - PubMed
    1. Kennedy LB, Salama AKS. A Review of Cancer Immunotherapy Toxicity. CA Cancer J Clin (2020) 70(2):86–104. 10.3322/caac.21596 - DOI - PubMed
    1. Wei SC, Duffy CR, Allison JP. Fundamental Mechanisms of Immune Checkpoint Blockade Therapy. Cancer Discovery (2018) 8:1069–86. 10.1158/2159-8290.CD-18-0367 - DOI - PubMed
    1. Postow MA, Sidlow R, Hellmann MD. Immune-Related Adverse Events Associated With Immune Checkpoint Blockade. N Engl J Med (2018) 378:158–68. 10.1056/NEJMra1703481 - DOI - PubMed
    1. Ettinger DS, Wood DE, Aisner DL, Akerley W, Bauman JR, Bharat A, et al. . NCCN Guidelines Insights: Non-Small Cell Lung Cancer, Version 2.2021. J Natl Compr Canc Netw (2021) 19(3):254–66. 10.6004/jnccn.2021.0013 - DOI - PubMed