Tumour microenvironment and immune evasion in EGFR addicted NSCLC: Hurdles and possibilities

Antonio Santaniello, Fabiana Napolitano, Alberto Servetto, Pietro De Placido, Nicola Silvestris, Cataldo Bianco, Luigi Formisano, Roberto Bianco

Research output: Contribution to journalReview articlepeer-review


In the last few years, the treatment strategy in Non-Small Cell Lung Cancer (NSCLC) patients has been heavily modified by the introduction of the immune-checkpoint inhibitors. Anti-programmed cell death 1/programmed cell death ligand 1 (PD-1/PD-L1) therapy has improved both progression-free and the overall survival in almost all subgroups of patients, with or without PDL1 expression, with different degrees of responses. However, there are patients that are not benefitting from this treatment. A defined group of immune-checkpoint inhibitors non-responder tumours carry EGFR (epidermal growth factor receptor) mutations: nowadays, anti-PD-1/PD-L1 clinical trials often do not involve this type of patient and the use of immune-checkpoint inhibitors are under evaluation in this setting. Our review aims to elucidate the mechanisms underlying this resistance: we focused on evaluating the role of the tumour microenvironment, including infiltrating cells, cytokines, secreted factors, and angiogenesis, and its interaction with the tumour tissue. Finally, we analysed the possible role of immunotherapy in EGFR mutated tumours.

Original languageEnglish
Article numberE1419
Issue number10
Publication statusPublished - Oct 2019


  • Angiogenesis
  • EGFR mutation
  • ICI
  • Immune checkpoint inhibitors
  • TKI
  • TMB
  • TME
  • Tumour microenvironment
  • Tumour mutational burden

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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