Second-line treatment for advanced NSCLC without actionable mutations: Is immunotherapy the 'panacea' for all patients?

Research output: Contribution to journalComment/debate

Abstract

The therapeutic approach for the second-line treatment of patients with advanced non-small cell lung cancer (NSCLC) without actionable mutations has been revolutionized by the recent approval of new effective drugs with various mechanisms of action, including nintedanib, ramucirumab, nivolumab, pembrolizumab, atezolizumab, and afatinib. The recent network meta-analysis of Créquit et al. (BMC Medicine, 15:193, 2017) compared the effectiveness and tolerability of the second-line treatments for advanced NSCLC with wild-type or unknown status for EGFR. The authors found that immunotherapy might be more efficacious than the currently recommended treatments. However, their meta-analysis does not take into account the role of predictive biomarkers - this is indeed a crucial point in the decision-making process considering that only a fraction of advanced NSCLC patients might derive a long-term benefit from second-line immunotherapy. The identification of molecular biomarkers that can predict a response to immune checkpoints, angiogenesis, and EGFR inhibitors remains an important goal of clinical research in order to maximize the benefit of these agents and to aid clinicians in the decision-making process. Please see related article: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0954-x

Original languageEnglish
Article number24
JournalBMC Medicine
Volume16
Issue number1
DOIs
Publication statusPublished - Feb 16 2018

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Non-Small Cell Lung Carcinoma
Immunotherapy
Mutation
Decision Making
Biomarkers
Drug Approval
Angiogenesis Inhibitors
Therapeutics
Meta-Analysis
Medicine
Research

Keywords

  • Afatinib
  • Atezolizumab
  • Docetaxel
  • Erlotinib
  • Nintedanib
  • Nivolumab
  • NSCLC
  • Pembrolizumab
  • Pemetrexed
  • Ramucirumab
  • Second-line therapy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Second-line treatment for advanced NSCLC without actionable mutations: Is immunotherapy the 'panacea' for all patients?",
abstract = "The therapeutic approach for the second-line treatment of patients with advanced non-small cell lung cancer (NSCLC) without actionable mutations has been revolutionized by the recent approval of new effective drugs with various mechanisms of action, including nintedanib, ramucirumab, nivolumab, pembrolizumab, atezolizumab, and afatinib. The recent network meta-analysis of Cr{\'e}quit et al. (BMC Medicine, 15:193, 2017) compared the effectiveness and tolerability of the second-line treatments for advanced NSCLC with wild-type or unknown status for EGFR. The authors found that immunotherapy might be more efficacious than the currently recommended treatments. However, their meta-analysis does not take into account the role of predictive biomarkers - this is indeed a crucial point in the decision-making process considering that only a fraction of advanced NSCLC patients might derive a long-term benefit from second-line immunotherapy. The identification of molecular biomarkers that can predict a response to immune checkpoints, angiogenesis, and EGFR inhibitors remains an important goal of clinical research in order to maximize the benefit of these agents and to aid clinicians in the decision-making process. Please see related article: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0954-x",
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