Immune checkpoint inhibitors in non-small-cell lung cancer: key to long-term survival?
Mené sur 550 patients atteints d'un cancer du poumon non à petites cellules, de stade avancé, cet essai de phase I évalue l'efficacité, du point de vue de la proportion de patients obtenant une réponse objective, de la durée de la réponse, de la survie globale et de la survie sans progression à 3 ans, et la toxicité du pembrolizumab (durée médiane de suivi : 34,5 mois)
Since the first approval of immune checkpoint inhibitors (ICIs) for non-small-cell lung cancer in 2015, the treatment landscape of metastatic non-small-cell lung cancer has changed completely. At this point, three programmed death-ligand 1 (PD-[L]1) inhibitors are approved for stage 4 non-small-cell lung cancer, in first line (pembrolizumab) and beyond (nivolumab, pembrolizumab, atezolizumab). All trials showed significantly improved overall survival compared with chemotherapy; the plateau in survival curves suggests long-term benefit. This resulted in rapid implementation of ICIs in daily practice. However, not all patients benefit from ICI because in several trials survival curves crossed and, although grade greater than or equal to 3 toxicity is lower for monotherapy ICI than chemotherapy, ICI can cause diverse and late toxicity, even after discontinuation
The Lancet Respiratory Medicine , commentaire, 2018