Choosing the best first-line therapy: NSCLC with no actionable oncogenic driver.

Combination platinum-based therapy has been the standard of care for the treatment of advanced non-small-cell lung cancer (NSCLC). Immunotherapy has emerged and demonstrated to show benefit in the treatment of patients with advanced NSCLC. In this review, we discuss the pivotal trials that led to the US FDA approval of specific immunotherapy regimens in particular patient populations. We discuss the optimal use of immunotherapy as monotherapy based on the KEYNOTE-024, KEYNOTE-042 and IMpower110 trials, chemo-immunotherapy based on KEYNOTE-189, KEYNOTE-407, IMpower150 and IMpower130 trials, and as doublet immunotherapy based on CheckMate-227. We also discuss the role and limitations of PD-L1 expression and tumor mutational burden as predictive biomarkers in response to single-agent immunotherapy and combination chemoimmunotherapy. Furthermore, we discuss emerging resistance markers such as

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© 2020 Balazs Halmos.

Déclaration de conflit d'intérêts

Financial & competing interests disclosure B Halmos has consulting roles at Astra Zeneca, BMS, Merck, Boehringer-Ingelheim, Novartis, Pfizer, Amgen, Spectrum, Takeda, Guardant Health, Foundation One and Genentech Research. Funding to institution: Merck, BMS, AbbVie, Advaxis, Guardant Health, Novartis, GSK, Astra Zeneca, Boehringer-Ingelheim, Genentech, Eli-Lilly, Amgen and Mirati. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.