Review article
Immunotherapy in the treatment of non-small cell lung cancer
Marko Jakopović
orcid.org/0000-0002-4815-7512
; Department for Respiratory Diseaes Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Lela Bitar
; Department for Respiratory Diseaes Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
Kristina Krpina
; Department for Respiratory Diseaes Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
Davorka Muršić
; Department for Respiratory Diseaes Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
Fran Seiwerth
; Department for Respiratory Diseaes Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
Mateja Janković
; Department for Respiratory Diseaes Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Miroslav Samardžija
; Department for Respiratory Diseaes Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Abstract
Lung cancer is leading cause of death among malignant disease Worldwide and it is responsible for more than 1, 5 million deaths each year. Lung cancer is divided in two major groups: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Despite significant improvements, for vast majority of patients chemotherapy still remains the treatment of choice in the first line setting. Progress over the last decade has led to the recognition of immunoevasion as of the leading hallmarks of cancer development. Clinical development was focused on immune checkpoint inhibitors, cytotoxic T-lymphocyte–associated antigen 4 (CTLA4) and programmed death (PD1/PD-L1) pathway. Programmed death 1 protein is another T-cell coinhibitory receptor with a structure similar to that of CTLA-4 but with a distinct biologic function and ligand specificity and it is stimulated with PD-L1. PD-1 or PD-L1 blockade with drugs like nivolumab, pembrolizumab or atezolizumab resulted in superior efficacy comparing to standard chemotherapy in first-line setting. In patient with high PD-L1 expression (50% or more) pemborlizumab should be treatment of choice in first-line setting. PD-L1 expression is at the moment only available biomarker who can predict response to immune checkpoint inhibitors.
Keywords
lung cancer; checkpoint inhibitors; immunotherapy
Hrčak ID:
192142
URI
Publication date:
21.12.2017.
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