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Immunotherapy in nonsmall-cell lung cancer: current status and future prospects for liquid biopsy

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Abstract

Immunotherapy has been one of the great advances in the recent years for the treatment of advanced tumors, with nonsmall-cell lung cancer (NSCLC) being one of the cancers that has benefited most from this approach. Currently, the only validated companion diagnostic test for first-line immunotherapy in metastatic NSCLC patients is testing for programmed death ligand 1 (PD-L1) expression in tumor tissues. However, not all patients experience an effective response with the established selection criteria and immune checkpoint inhibitors (ICIs). Liquid biopsy offers a noninvasive opportunity to monitor disease in patients with cancer and identify those who would benefit the most from immunotherapy. This review focuses on the use of liquid biopsy in immunotherapy treatment of NSCLC patients. Circulating tumor cells (CTCs), cell-free DNA (cfDNA) and exosomes are promising tools for developing new biomarkers. We discuss the current application and future implementation of these parameters to improve therapeutic decision-making and identify the patients who will benefit most from immunotherapy.

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Funding

This study was financed by all the donors who participated in the Liquid Biopsy Crowdfunding campaign in 2017.

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Author notes

  1. Elena María Brozos-Vázquez and Roberto Díaz-Peña Contributed equally.

Authors and Affiliations

  1. Department of Medical Oncology, Complexo Hospitalario Universitario de Santiago de Compostela, 15706, Santiago de Compostela, Spain

    Elena María Brozos-Vázquez, Jorge García-González, Luis León-Mateos & Rafael López-López

  2. Liquid Biopsy Analysis Unit, Translational Medical Oncology (Oncomet), Health Research Institute of Santiago (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela, 15706, Santiago de Compostela, Spain

    Elena María Brozos-Vázquez, Roberto Díaz-Peña, Jorge García-González, Luis León-Mateos, Patricia Mondelo-Macía & Rafael López-López

  3. Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029, Madrid, Spain

    Roberto Díaz-Peña, Jorge García-González, Luis León-Mateos & Rafael López-López

  4. Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, 3460000, Chile

    Roberto Díaz-Peña

  5. Bioinformatics in Rare Diseases (BiER), Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), 41013, Sevilla, Spain

    María Peña-Chilet

  6. Clinical Bioinformatics Area, Fundación Progreso y Salud (FPS), Hospital Virgen del Rocío, 41013, Sevilla, Spain

    María Peña-Chilet

  7. Institute of Biomedicine of Sevilla (IBiS, CSIC, Universidad de Sevilla), 41013, Sevilla, Spain

    María Peña-Chilet

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  1. Elena María Brozos-Vázquez
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Contributions

EMBV and RDP designed the manuscript, and collected the material and data necessary to construct the article. JGG, LLM, PMM, MPC, and RLL provided supervisory support and constructive critique of the article to enable revisions. All authors helped to write the manuscript.

Corresponding authors

Correspondence to Elena María Brozos-Vázquez or Roberto Díaz-Peña.

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Conflict of interest

Rafael López-López has received honoraria for participation in Advisory Boards from Roche, AstraZeneca, Merck, MSD, Bayer, BMS, Novartis, Janssen, Lilly, Pfizer and Leo; travel, accommodations and expenses from Pharmamar, Roche, BMS and Pierre Fabre; research funding from Roche and Merck; and is co-founder and shareholder in Nasasbiotech, S.L., Mtrap Inc. Luis León-Mateos reports personal fees from AstraZeneca, Boehringer-Ingelheim, Novartis, Jansen, Astellas and Sanofi; and personal fees and nonfinancial support from Bristol-Myers Squibb, Lilly, MSD and Roche, outside the submitted work. Jorge García-González reports personal fees from AstraZeneca, Boehringer-Ingelheim, Novartis, Pierre Fabre, Rovi and Sanofi; and personal fees and nonfinancial support from Bristol-Myers Squibb, Lilly, MSD and Roche, outside the submitted work. Elena Brozos-Vázquez reports personal fees from Leo Pharma, Rovi, and travel grants from Merck, Sanofi, Roche, Pierre-Frabre and Amgen, outside the submitted work.

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Brozos-Vázquez, E.M., Díaz-Peña, R., García-González, J. et al. Immunotherapy in nonsmall-cell lung cancer: current status and future prospects for liquid biopsy. Cancer Immunol Immunother 70, 1177–1188 (2021). https://doi.org/10.1007/s00262-020-02752-z

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