Nuria Pardo

Immune-checkpoint inhibition in first-line treatment of advanced non-small cell lung cancer patients: Current status and future approaches

Immune checkpoint inhibitors are considered standard second-line treatment in advanced non-small cell lung cancer patients. This strategy has also become standard in first-line setting for a subgroup of patients with strongly positive PD-L1 tumors; therefore, PD-L1 status might be considered a new biomarker that deserves upfront testing. New combinations of immune checkpoint inhibitors and with chemotherapy have been tested in first-line treatment. However, some questions remain unanswered such as the best treatment strategy or the real upfront efficacy of these therapeutic strategies in the whole lung cancer population. In this review we summarize the main results in the first-line setting of recent phase III trials with immune checkpoint inhibitors in advanced non-small cell lung cancer patients.

Targeting EML4-ALK driven non-small cell lung cancer (NSCLC)

Recently, due to key discoveries relating to the molecular biology of many cancers and the development of effective and specific targeted treatments, the ability to personalize cancer therapy based on individual patient genotypes has become a reality in clinical practice (1). Some examples of this genotype-specific approach to anti-cancer therapeutics are BCR-ABL targeted therapy in chronic myelogenous leukemia, C-KIT inhibition in gastrointestinal stromal tumors, the use of Kristen rat sarcoma (KRAS) to negatively select EGFR inhibitors in colon cancer, HER2-directed therapy in breast cancer, and BRAF inhibitors in melanoma (2-13). Several other therapies are currently under investigation in clinical trials and will likely soon broaden this list further.

靶向EML4-ALK 驱动的非小细胞肺癌

近年来，得益于多种肿瘤分子生物学研究和 有效特异性靶向治疗发展的重大发现，根据患者 基因型的肿瘤个体化治疗已在临床实践中成为可 能[1]。这种基因型特异性抗肿瘤治疗方法有很多， 比如BCR-ABL靶向治疗慢性粒细胞白血病，C-KIT 抑制剂治疗胃肠道间质瘤，KRAS在EGFR抑制剂 无反应的结肠癌中的应用，乳腺癌的HER2导向治 疗以及BRAF抑制剂治疗黑色素瘤[2-13]。其他一些 治疗方案正在临床研究中，这将在不久的将来有 可能拓宽基因个体化治疗的这个范围。