Beyond first-line immunotherapy: Potential therapeutic strategies based on different pattern progressions: Oligo and systemic progression

Arsela Prelaj, Chiara Carlotta Pircher, Giacomo Massa, Valentino Martelli, Giulia Corrao, Giuseppe Lo Russo, Claudia Proto, Roberto Ferrara, Giulia Galli, Alessandro De Toma, Carlo Genova, Barbara Alicja Jereczek-Fossa, Filippo de Braud, Marina Chiara Garassino, Sara Elena Rebuzzi

Research output: Contribution to journalReview articlepeer-review

Abstract

First-line immune-checkpoint inhibitor (ICI)-based therapy has deeply changed the treatment landscape and prognosis in advanced non-small cell lung cancer (aNSCLC) patients with no targetable alterations. Nonetheless, a percentage of patients progressed on ICI as monotherapy or combinations. Open questions remain on patients’ selection, the identification of biomarkers of primary resistance to immunotherapy and the treatment strategies to overcome secondary resistance to first-line immunotherapy. Local ablative approaches are the main therapeutic strategies in oligoprogressive disease, and their role is emerging in patients treated with immunotherapy. Many therapeutic strategies can be adapted in aNSCLC patients with systemic progression to person-alize the treatment approach according to re-characterization of the tumors, previous ICI response, and type of progression. This review’s aim is to highlight and discuss the current and potential therapeutic approaches beyond first-line ICI-based therapy in aNSCLC patients based on the pattern of disease progression (oligoprogression versus systemic progression).

Original languageEnglish
Article number1300
Pages (from-to)1-22
Number of pages22
JournalCancers
Volume13
Issue number6
DOIs
Publication statusPublished - Mar 2 2021

Keywords

  • Immune checkpoint inhibitor
  • Immunotherapy
  • Local therapy
  • Non-small cell lung cancer
  • Oligoprogression
  • Resistance

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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