Immune Checkpoint Inhibitor‐Based Therapy as the First‐Line Treatment for Advanced Non‐Small Cell Lung Cancer: Efficacy, Challenges, and Future Perspectives
ABSTRACT The selection of initial systemic treatment for advanced non‐small cell lung cancer (NSCLC) depends on histological subtypes, oncogenic driver identification through genomic profiling, and programmed death‐ligand 1 (PD‐L1) expression quantification. The choice of first‐line treatment is cru...
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| Format: | Article |
| Language: | English |
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Wiley
2025-06-01
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| Series: | Thoracic Cancer |
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| Online Access: | https://doi.org/10.1111/1759-7714.70113 |
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| author | Xingxiang Pu Yu Zhou Jingyi Wang Lin Wu |
| author_facet | Xingxiang Pu Yu Zhou Jingyi Wang Lin Wu |
| author_sort | Xingxiang Pu |
| collection | DOAJ |
| description | ABSTRACT The selection of initial systemic treatment for advanced non‐small cell lung cancer (NSCLC) depends on histological subtypes, oncogenic driver identification through genomic profiling, and programmed death‐ligand 1 (PD‐L1) expression quantification. The choice of first‐line treatment is crucial as patients with advanced NSCLC may not have the opportunity to receive second‐ or later‐line therapies due to the rapid progression of the disease. Current guidelines recommend pretreatment PD‐L1 expression quantification evaluation prior to initiating systemic therapy in advanced NSCLC. Except for histology, PD‐L1 expression, and absence of actionable driver mutations, single‐agent immune checkpoint inhibitors (ICIs) are foundational first‐line interventions. ICIs combined with chemotherapy or other ICIs have shown improved survival outcomes compared to ICI monotherapy. However, choosing the best option can be challenging due to limited head‐to‐head comparisons. Treatment decisions are often influenced by drug availability, reimbursement coverage, and patient's economic conditions. Despite the development of new ICI therapies, overall survival data seem to have plateaued, highlighting the need for sustained investigations and extensive clinical validation studies to develop novel therapies, optimize ICI combinations, and monitor adverse effects. Collaboration among data scientists, clinicians, biologists, and policymakers is essential to establish biomarkers that enhance patient selection and overall survival in NSCLC. |
| format | Article |
| id | doaj-art-d8c7760f79df42648477c441144e93c4 |
| institution | Kabale University |
| issn | 1759-7706 1759-7714 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj-art-d8c7760f79df42648477c441144e93c42025-08-20T03:29:58ZengWileyThoracic Cancer1759-77061759-77142025-06-011612n/an/a10.1111/1759-7714.70113Immune Checkpoint Inhibitor‐Based Therapy as the First‐Line Treatment for Advanced Non‐Small Cell Lung Cancer: Efficacy, Challenges, and Future PerspectivesXingxiang Pu0Yu Zhou1Jingyi Wang2Lin Wu3Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital Changsha ChinaThe Second Department of Thoracic Oncology The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital Changsha ChinaXiangya Lung Cancer Center, Xiangya Hospital, Central South University Changsha ChinaThe Second Department of Thoracic Oncology The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital Changsha ChinaABSTRACT The selection of initial systemic treatment for advanced non‐small cell lung cancer (NSCLC) depends on histological subtypes, oncogenic driver identification through genomic profiling, and programmed death‐ligand 1 (PD‐L1) expression quantification. The choice of first‐line treatment is crucial as patients with advanced NSCLC may not have the opportunity to receive second‐ or later‐line therapies due to the rapid progression of the disease. Current guidelines recommend pretreatment PD‐L1 expression quantification evaluation prior to initiating systemic therapy in advanced NSCLC. Except for histology, PD‐L1 expression, and absence of actionable driver mutations, single‐agent immune checkpoint inhibitors (ICIs) are foundational first‐line interventions. ICIs combined with chemotherapy or other ICIs have shown improved survival outcomes compared to ICI monotherapy. However, choosing the best option can be challenging due to limited head‐to‐head comparisons. Treatment decisions are often influenced by drug availability, reimbursement coverage, and patient's economic conditions. Despite the development of new ICI therapies, overall survival data seem to have plateaued, highlighting the need for sustained investigations and extensive clinical validation studies to develop novel therapies, optimize ICI combinations, and monitor adverse effects. Collaboration among data scientists, clinicians, biologists, and policymakers is essential to establish biomarkers that enhance patient selection and overall survival in NSCLC.https://doi.org/10.1111/1759-7714.70113first‐line treatmentimmune checkpoint inhibitorNSCLCPD‐L1 |
| spellingShingle | Xingxiang Pu Yu Zhou Jingyi Wang Lin Wu Immune Checkpoint Inhibitor‐Based Therapy as the First‐Line Treatment for Advanced Non‐Small Cell Lung Cancer: Efficacy, Challenges, and Future Perspectives Thoracic Cancer first‐line treatment immune checkpoint inhibitor NSCLC PD‐L1 |
| title | Immune Checkpoint Inhibitor‐Based Therapy as the First‐Line Treatment for Advanced Non‐Small Cell Lung Cancer: Efficacy, Challenges, and Future Perspectives |
| title_full | Immune Checkpoint Inhibitor‐Based Therapy as the First‐Line Treatment for Advanced Non‐Small Cell Lung Cancer: Efficacy, Challenges, and Future Perspectives |
| title_fullStr | Immune Checkpoint Inhibitor‐Based Therapy as the First‐Line Treatment for Advanced Non‐Small Cell Lung Cancer: Efficacy, Challenges, and Future Perspectives |
| title_full_unstemmed | Immune Checkpoint Inhibitor‐Based Therapy as the First‐Line Treatment for Advanced Non‐Small Cell Lung Cancer: Efficacy, Challenges, and Future Perspectives |
| title_short | Immune Checkpoint Inhibitor‐Based Therapy as the First‐Line Treatment for Advanced Non‐Small Cell Lung Cancer: Efficacy, Challenges, and Future Perspectives |
| title_sort | immune checkpoint inhibitor based therapy as the first line treatment for advanced non small cell lung cancer efficacy challenges and future perspectives |
| topic | first‐line treatment immune checkpoint inhibitor NSCLC PD‐L1 |
| url | https://doi.org/10.1111/1759-7714.70113 |
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