Immune Checkpoint Inhibitors for the Treatment of Unresectable Stage III Non–Small Cell Lung Cancer: Emerging Mechanisms and Perspectives

Immune Checkpoint Inhibitors for the Treatment of Unresectable Stage III Non–Small Cell Lung Cancer: Emerging Mechanisms and Perspectives

Hiroyuki Inoue,1,2 Isamu Okamoto1 1Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 2Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, JapanCorrespondence: Isamu OkamotoResearch Institute for Dise...

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Autores principales: Inoue H, Okamoto I
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2020
Materias:
durvalumab
pd-l1
immunogenic cell death
lung cancer
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Acceso en línea:https://doaj.org/article/723fb2720b0041fd8d3e8067056674ad
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spelling oai:doaj.org-article:723fb2720b0041fd8d3e8067056674ad2021-12-02T05:28:13ZImmune Checkpoint Inhibitors for the Treatment of Unresectable Stage III Non–Small Cell Lung Cancer: Emerging Mechanisms and Perspectives1179-2728https://doaj.org/article/723fb2720b0041fd8d3e8067056674ad2020-01-01T00:00:00Zhttps://www.dovepress.com/immune-checkpoint-inhibitors-for-the-treatment-of-unresectable-stage-i-peer-reviewed-article-LCTThttps://doaj.org/toc/1179-2728Hiroyuki Inoue,1,2 Isamu Okamoto1 1Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 2Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, JapanCorrespondence: Isamu OkamotoResearch Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, JapanTel +81-92-642-5378Fax +81-92-642-5390Email okamotoi@kokyu.med.kyushu-u.ac.jpAbstract: There has been no improvement in outcome for patients with unresectable locally advanced (stage III) non–small cell lung cancer (NSCLC) for more than 10 years. The standard treatment for these patients is definitive concurrent chemotherapy and radiation (CCRT). Although the goal of treatment in this setting is to achieve a cure, most patients progress and their prognosis is poor, with a 5-year survival rate of 15–30%. There is thus an urgent need for the development of novel anticancer treatments in this patient population. Recent advances in cancer immunotherapy have led to a marked improvement in clinical outcome for advanced NSCLC. Such immunotherapy mainly consists of the administration of immune checkpoint inhibitors (ICIs) such as antibodies to cytotoxic T lymphocyte–associated protein–4 (CTLA-4) or to either programmed cell death–1 (PD-1) or its ligand PD-L1. Durvalumab (MEDI4736) is a high-affinity human immunoglobulin G1 monoclonal antibody that blocks the binding of PD-L1 on tumor cells or antigen-presenting cells to PD-1 on T cells. The PACIFIC study recently evaluated consolidation immunotherapy with durvalumab versus placebo administered after concurrent chemoradiotherapy (CCRT) in patients with unresectable stage III NSCLC. It revealed a significant improvement in both progression-free and overall survival with durvalumab, and this improvement was associated with a favorable safety profile. This achievement has made durvalumab a standard of care for consolidation after CCRT in patients with unresectable stage III NSCLC, and it has now been approved in this setting by regulatory agencies in the United States, Canada, Japan, Australia, Switzerland, Malaysia, Singapore, India, and the United Arab Emirates. In this review, we briefly summarize the results of the PACIFIC trial, including those of post hoc analysis, and we address possible molecular mechanisms, perspectives, and remaining questions related to combined treatment with CCRT and ICIs in this patient population.Keywords: durvalumab, PD-L1, immunogenic cell death, lung cancerInoue HOkamoto IDove Medical Pressarticledurvalumabpd-l1immunogenic cell deathlung cancerNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENLung Cancer: Targets and Therapy, Vol Volume 10, Pp 161-170 (2020)
institution DOAJ
collection DOAJ
language EN
topic durvalumab
pd-l1
immunogenic cell death
lung cancer
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
spellingShingle durvalumab
pd-l1
immunogenic cell death
lung cancer
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Inoue H
Okamoto I
Immune Checkpoint Inhibitors for the Treatment of Unresectable Stage III Non–Small Cell Lung Cancer: Emerging Mechanisms and Perspectives
description Hiroyuki Inoue,1,2 Isamu Okamoto1 1Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 2Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, JapanCorrespondence: Isamu OkamotoResearch Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, JapanTel +81-92-642-5378Fax +81-92-642-5390Email okamotoi@kokyu.med.kyushu-u.ac.jpAbstract: There has been no improvement in outcome for patients with unresectable locally advanced (stage III) non–small cell lung cancer (NSCLC) for more than 10 years. The standard treatment for these patients is definitive concurrent chemotherapy and radiation (CCRT). Although the goal of treatment in this setting is to achieve a cure, most patients progress and their prognosis is poor, with a 5-year survival rate of 15–30%. There is thus an urgent need for the development of novel anticancer treatments in this patient population. Recent advances in cancer immunotherapy have led to a marked improvement in clinical outcome for advanced NSCLC. Such immunotherapy mainly consists of the administration of immune checkpoint inhibitors (ICIs) such as antibodies to cytotoxic T lymphocyte–associated protein–4 (CTLA-4) or to either programmed cell death–1 (PD-1) or its ligand PD-L1. Durvalumab (MEDI4736) is a high-affinity human immunoglobulin G1 monoclonal antibody that blocks the binding of PD-L1 on tumor cells or antigen-presenting cells to PD-1 on T cells. The PACIFIC study recently evaluated consolidation immunotherapy with durvalumab versus placebo administered after concurrent chemoradiotherapy (CCRT) in patients with unresectable stage III NSCLC. It revealed a significant improvement in both progression-free and overall survival with durvalumab, and this improvement was associated with a favorable safety profile. This achievement has made durvalumab a standard of care for consolidation after CCRT in patients with unresectable stage III NSCLC, and it has now been approved in this setting by regulatory agencies in the United States, Canada, Japan, Australia, Switzerland, Malaysia, Singapore, India, and the United Arab Emirates. In this review, we briefly summarize the results of the PACIFIC trial, including those of post hoc analysis, and we address possible molecular mechanisms, perspectives, and remaining questions related to combined treatment with CCRT and ICIs in this patient population.Keywords: durvalumab, PD-L1, immunogenic cell death, lung cancer
format article
author Inoue H
Okamoto I
author_facet Inoue H
Okamoto I
author_sort Inoue H
title Immune Checkpoint Inhibitors for the Treatment of Unresectable Stage III Non–Small Cell Lung Cancer: Emerging Mechanisms and Perspectives
title_short Immune Checkpoint Inhibitors for the Treatment of Unresectable Stage III Non–Small Cell Lung Cancer: Emerging Mechanisms and Perspectives
title_full Immune Checkpoint Inhibitors for the Treatment of Unresectable Stage III Non–Small Cell Lung Cancer: Emerging Mechanisms and Perspectives
title_fullStr Immune Checkpoint Inhibitors for the Treatment of Unresectable Stage III Non–Small Cell Lung Cancer: Emerging Mechanisms and Perspectives
title_full_unstemmed Immune Checkpoint Inhibitors for the Treatment of Unresectable Stage III Non–Small Cell Lung Cancer: Emerging Mechanisms and Perspectives
title_sort immune checkpoint inhibitors for the treatment of unresectable stage iii non–small cell lung cancer: emerging mechanisms and perspectives
publisher Dove Medical Press
publishDate 2020
url https://doaj.org/article/723fb2720b0041fd8d3e8067056674ad
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