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J Immunother Cancer. 2018 Jul 17;6(1):75. doi: 10.1186/s40425-018-0382-2.

The Society for Immunotherapy of Cancer consensus statement on immunotherapy for the treatment of non-small cell lung cancer (NSCLC).

Author information

1
Bloomberg Kimmel Immunotherapy Institute, Johns Hopkins Kimmel Cancer Center, Baltimore, MD, 21231, USA.
2
Division of Oncology, Washington University, St Louis, MO, 63110, USA.
3
Johns Hopkins School of Medicine, Baltimore, MD, 21231, USA.
4
H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612, USA.
5
Johns Hopkins Kimmel Cancer Center, Baltimore, MD, 21231, USA.
6
Yale Comprehensive Cancer Center, Yale University School of Nursing, New Haven, CT, 06520, USA.
7
University of California Los Angeles Lung Cancer Research Program, David Geffen School of Medicine, University of California, Los Angeles, CA, 90095, USA.
8
LUNGevity, Chicago, IL, 60604, USA.
9
Department of Medicine, New York University, Perlmutter Cancer Center, NYU School of Medicine, New York, NY, 10016, USA.
10
Division of Hematology-Oncology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, 90404, USA.
11
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
12
University of Colorado Denver School of Medicine, Denver, CO, 80011, USA.
13
National Cancer Institute, Division of Cancer Treatment and Diagnosis, Cancer Therapy Evaluation Program, Rockville, USA.
14
Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
15
University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
16
Department of Pathology, Yale University School of Medicine, New Haven, CT, 06520, USA.
17
Department of Radiology, Columbia University College of Physicians and Surgeons and New York Presbyterian Hospital, New York City, NY, 10032, USA.
18
Thoracic Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
19
Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
20
Columbia University Medical Center, New York, NY, 10028, USA.
21
Yale Comprehensive Cancer Center, Yale School of Medicine, 333 Cedar Street, WWW221, New Haven, CT, 06520-8028, USA. roy.herbst@yale.edu.

Abstract

Lung cancer is the leading cause of cancer-related mortality worldwide, with non-small cell lung cancer (NSCLC) accounting for over 85% of all cases. Until recently, chemotherapy - characterized by some benefit but only rare durable responses - was the only treatment option for patients with NSCLC whose tumors lacked targetable mutations. By contrast, immune checkpoint inhibitors have demonstrated distinctly durable responses and represent the advent of a new treatment approach for patients with NSCLC. Three immune checkpoint inhibitors, pembrolizumab, nivolumab and atezolizumab, are now approved for use in first- and/or second-line settings for selected patients with advanced NSCLC, with promising benefit also seen in patients with stage III NSCLC. Additionally, durvalumab following chemoradiation has been approved for use in patients with locally advanced disease. Due to the distinct features of cancer immunotherapy, and rapid progress in the field, clinical guidance is needed on the use of these agents, including appropriate patient selection, sequencing of therapies, response monitoring, adverse event management, and biomarker testing. The Society for Immunotherapy of Cancer (SITC) convened an expert Task Force charged with developing consensus recommendations on these key issues. Following a systematic process as outlined by the National Academy of Medicine, a literature search and panel voting were used to rate the strength of evidence for each recommendation. This consensus statement provides evidence-based recommendations to help clinicians integrate immune checkpoint inhibitors into the treatment plan for patients with NSCLC. This guidance will be updated following relevant advances in the field.

KEYWORDS:

Cancer immunotherapy; Consensus statement; Guideline; Lung cancer; Non-small cell lung cancer

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