New PD-L1 inhibitors in non-small cell lung cancer – impact of atezolizumab

Nagashree Seetharamu, Isabel R Preeshagul, Kevin M Sullivan Monter Cancer Center, Hofstra-Northwell Health School of Medicine, Lake Success, NY, USA Abstract: The era of immunotherapy has changed the face of how we approach treatment for many oncologic and hematologic malignancies....

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Autores principales: Seetharamu N, Preeshagul IR, Sullivan KM
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Publicado: Dove Medical Press 2017
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spelling oai:doaj.org-article:8a0a5dfc63c14e2b808511bcd61aa5dd2021-12-02T08:34:49ZNew PD-L1 inhibitors in non-small cell lung cancer – impact of atezolizumab1179-2728https://doaj.org/article/8a0a5dfc63c14e2b808511bcd61aa5dd2017-07-01T00:00:00Zhttps://www.dovepress.com/new-pd-l1-inhibitors-in-non-small-cell-lung-cancer-impact-of-atezolizu-peer-reviewed-article-LCTThttps://doaj.org/toc/1179-2728Nagashree Seetharamu, Isabel R Preeshagul, Kevin M Sullivan Monter Cancer Center, Hofstra-Northwell Health School of Medicine, Lake Success, NY, USA Abstract: The era of immunotherapy has changed the face of how we approach treatment for many oncologic and hematologic malignancies. Lung cancer has been in the forefront of checkpoint inhibition for the past 2 years and has paved the path for other subspecialties. While PD-1 inhibitors nivolumab and pembrolizumab have been approved for non-small cell lung cancer (NSCLC), this review focuses on atezolizumab, its landmark studies, and ongoing trials. Atezolizumab is the first programmed death ligand 1 (PD-L1) inhibitor to receive US Food and Drug Administration (FDA) approval for metastatic NSCLC patients who have progressed on frontline chemotherapy. This approval was based on two open-label Phase II multicenter trials, POPLAR (NCT01903993) and BIRCH (NCT02031458). Both studies revealed a benefit in overall survival (OS), progression-free survival, and response rate in the atezolizumab arm when compared to single-agent docetaxol. There were also fewest Grade 3–5 treatment-related adverse events (TRAEs) in the atezolizumab cohort. The open-label randomized Phase III OAK trial (NCT02008227) further established the role of atezolizumab in previously treated NSCLC. This study compared atezolizumab with docetaxel in patients with advanced NSCLC (squamous or nonsquamous histologies) who had progressed on one to two prior chemotherapy regimens. OS in the PD-L1-enriched population was superior in the atezolizumab arm (n=241) at 15.7 months compared with docetaxel (n=222) at 10.3 months (hazard ratio [HR] 0.74, 95% confidence interval [CI] 0.58–0.93; p=0.0102). Patients lacking PD-L1 also had survival benefit with atezolizumab with a median OS (mOS) of 12.6 months versus 8.9 months with chemotherapy (HR 0.75, 95% CI 0.59–0.96). Benefit was noted in both squamous and nonsquamous NSCLC subsets and regardless of PD-L1 expressivity. As seen in the POPLAR and BIRCH studies, the toxicity profile was significantly better with immunotherapy. The future is unfolding rapidly as new checkpoint inhibitors are gaining FDA approval. It is still not known if these agents will be used in combination with chemotherapy, with other immune-modulating agents, radiation therapy, or all of the above. The results of these studies investigating their use in combination with chemotherapy agents, with other immunotherapy agents such as CTLA-4 inhibitors, and with radiation therapy, are eagerly awaited. Keywords: PD-1, PD-L1, ADCC, CDC,checkpoint inhibition Seetharamu NPreeshagul IRSullivan KMDove Medical PressarticleImmunotherapyAtezolizumabPembrolizumabNivolumabCheckpoint inhibitorsNon Small Cell Lung Cancer.Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENLung Cancer: Targets and Therapy, Vol Volume 8, Pp 67-78 (2017)
institution DOAJ
collection DOAJ
language EN
topic Immunotherapy
Atezolizumab
Pembrolizumab
Nivolumab
Checkpoint inhibitors
Non Small Cell Lung Cancer.
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
spellingShingle Immunotherapy
Atezolizumab
Pembrolizumab
Nivolumab
Checkpoint inhibitors
Non Small Cell Lung Cancer.
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Seetharamu N
Preeshagul IR
Sullivan KM
New PD-L1 inhibitors in non-small cell lung cancer – impact of atezolizumab
description Nagashree Seetharamu, Isabel R Preeshagul, Kevin M Sullivan Monter Cancer Center, Hofstra-Northwell Health School of Medicine, Lake Success, NY, USA Abstract: The era of immunotherapy has changed the face of how we approach treatment for many oncologic and hematologic malignancies. Lung cancer has been in the forefront of checkpoint inhibition for the past 2 years and has paved the path for other subspecialties. While PD-1 inhibitors nivolumab and pembrolizumab have been approved for non-small cell lung cancer (NSCLC), this review focuses on atezolizumab, its landmark studies, and ongoing trials. Atezolizumab is the first programmed death ligand 1 (PD-L1) inhibitor to receive US Food and Drug Administration (FDA) approval for metastatic NSCLC patients who have progressed on frontline chemotherapy. This approval was based on two open-label Phase II multicenter trials, POPLAR (NCT01903993) and BIRCH (NCT02031458). Both studies revealed a benefit in overall survival (OS), progression-free survival, and response rate in the atezolizumab arm when compared to single-agent docetaxol. There were also fewest Grade 3–5 treatment-related adverse events (TRAEs) in the atezolizumab cohort. The open-label randomized Phase III OAK trial (NCT02008227) further established the role of atezolizumab in previously treated NSCLC. This study compared atezolizumab with docetaxel in patients with advanced NSCLC (squamous or nonsquamous histologies) who had progressed on one to two prior chemotherapy regimens. OS in the PD-L1-enriched population was superior in the atezolizumab arm (n=241) at 15.7 months compared with docetaxel (n=222) at 10.3 months (hazard ratio [HR] 0.74, 95% confidence interval [CI] 0.58–0.93; p=0.0102). Patients lacking PD-L1 also had survival benefit with atezolizumab with a median OS (mOS) of 12.6 months versus 8.9 months with chemotherapy (HR 0.75, 95% CI 0.59–0.96). Benefit was noted in both squamous and nonsquamous NSCLC subsets and regardless of PD-L1 expressivity. As seen in the POPLAR and BIRCH studies, the toxicity profile was significantly better with immunotherapy. The future is unfolding rapidly as new checkpoint inhibitors are gaining FDA approval. It is still not known if these agents will be used in combination with chemotherapy, with other immune-modulating agents, radiation therapy, or all of the above. The results of these studies investigating their use in combination with chemotherapy agents, with other immunotherapy agents such as CTLA-4 inhibitors, and with radiation therapy, are eagerly awaited. Keywords: PD-1, PD-L1, ADCC, CDC,checkpoint inhibition 
format article
author Seetharamu N
Preeshagul IR
Sullivan KM
author_facet Seetharamu N
Preeshagul IR
Sullivan KM
author_sort Seetharamu N
title New PD-L1 inhibitors in non-small cell lung cancer – impact of atezolizumab
title_short New PD-L1 inhibitors in non-small cell lung cancer – impact of atezolizumab
title_full New PD-L1 inhibitors in non-small cell lung cancer – impact of atezolizumab
title_fullStr New PD-L1 inhibitors in non-small cell lung cancer – impact of atezolizumab
title_full_unstemmed New PD-L1 inhibitors in non-small cell lung cancer – impact of atezolizumab
title_sort new pd-l1 inhibitors in non-small cell lung cancer – impact of atezolizumab
publisher Dove Medical Press
publishDate 2017
url https://doaj.org/article/8a0a5dfc63c14e2b808511bcd61aa5dd
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AT sullivankm newpdl1inhibitorsinnonsmallcelllungcancerndashimpactofatezolizumab
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