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LUNG CANCER

Frontline immunotherapy for NSCLC — the tale of the tail

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The CHECKMATE-227 trial of nivolumab and ipilimumab presents a potential new frontline chemotherapy-sparing treatment option for patients with PD-L1-positive non-small-cell lung cancer and perhaps, in the future, also for those with PD-L1-negative disease. Indeed, the true predictive value of PD-L1 as well as tumour mutational burden remains to be determined, as neither biomarker segregates clearly with responsiveness.

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Fig. 1: Proposed first-line treatment algorithm for advanced-stage non-small-cell lung cancer without targetable driver mutations.

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Acknowledgements

The authors thank Scott Gettinger, Philip Grover, Mario Sznol and Yang Zhou for their input into the manuscript.

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Authors and Affiliations

  1. Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, CT, USA

    Anne C. Chiang & Roy S. Herbst

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  1. Anne C. Chiang
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  2. Roy S. Herbst
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Correspondence to Roy S. Herbst.

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Competing interests

R.S.H. has received honoraria for consultancy from Abbvie Pharmaceuticals, ARMO Biosciences, AstraZeneca, Biodesix, Bolt Biotherapeutics, Bristol-Myers Squibb, Eli Lilly, EMD Serrano, Genentech/Roche, Genmab, Halozyme, Heat Biologics, IMAB Biopharma, Immunocore, Infinity Pharmaceuticals, Loxo Oncology, Merck and Company, Midas Health Analytics, Nektar, Neon Therapeutics, NextCure, Novartis, Pfizer, Sanofi, Seattle Genetics, Shire PLC, Spectrum Pharmaceuticals, Symphogen, Takeda, Tesaro, and Tocagen. R.S.H. has also received research support from AstraZeneca, Eli Lilly and Merck, and is a member of the board of directors (non-executive/ independent) for Junshi Pharmaceuticals. A.C.C. has received honoraria for consultancy or participation on advisory boards from Abbvie Pharmaceuticals, AstraZeneca, Boehringer-Ingelheim, Bristol-Myers Squibb and Genentech/Roche. A.C.C. has also received research support from AbbVIe Pharmaceuticals, Amgen, AstraZeneca, Bristol-Myers Squibb, Eli Lilly and Merck.

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Chiang, A.C., Herbst, R.S. Frontline immunotherapy for NSCLC — the tale of the tail. Nat Rev Clin Oncol 17, 73–74 (2020). https://doi.org/10.1038/s41571-019-0317-y

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