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Ann Oncol. 2019 Mar 26. pii: mdz109. doi: 10.1093/annonc/mdz109. [Epub ahead of print]

How to Make the Best Use of Immunotherapy as First-Line Treatment for Advanced/Metastatic Non-Small-Cell Lung Cancer.

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University of Lausanne, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Lung Clinic Grosshansdorf, Airway Research Center North (ARCN), German Center of Lung Research (DZL), Grosshansdorf, Germany.
Department of Pulmonary Diseases, VU University Medical Centre, Amsterdam, Netherlands.
Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands.
Department of Clinical Oncology, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, and Parker Center for Cancer Immunotherapy, New York, NY, USA.


Antibodies that target programmed death 1 (PD-1) or its ligand (programmed death ligand 1 (PD-L1) have become a mainstay of first-line treatment of advanced/metastatic non-small-cell lung cancer (NSCLC) without targetable genetic alterations. In this review, we summarize results from recent clinical trials that have evaluated the anti-PD-1 antibodies pembrolizumab and nivolumab and the anti-PD-L1 antibodies atezolizumab and durvalumab as first-line treatment as monotherapy, in combination with chemotherapy, other immunotherapies, and anti-angiogenesis agents. We discuss factors that may influence treatment selection, including patient baseline clinical and demographic characteristics, tumor histology, and biomarkers such as PD-L1 expression and tumor mutation burden. While immunotherapy has become a central component of first-line treatment for most patients with advanced NSCLC, important questions remain about how treatment should be managed for individual patients.


atezolizumab; durvalumab; first-line; immunotherapy; ipilimumab; nivolumab; non-small-cell lung cancer; pembrolizumab


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