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Immune Checkpoint Inhibitors in Early-Stage and Locally Advanced Non-Small Cell Lung Cancer

  • Lung Cancer (HA Wakelee, Section Editor)
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Opinion statement

Surgical resection ± chemotherapy ± radiation or stereotactic body radiation therapy (SBRT) are established treatment modalities for resectable stage non-small cell lung cancer (NSCLC), and concurrent chemotherapy with radiation is the therapy of choice for unresectable locally advanced disease. Despite treatment with curative intent, most patients subsequently relapse and develop distant disease. Treatment with checkpoint inhibitors represents a major advancement in the treatment of metastatic NSCLC. Therapy against programed cell death-1/programmed cell death ligand 1 (PD-1/PD-L1) is associated with a significant improvement in overall survival in stage IV disease, and these results have led to a great interest in evaluating these agents in earlier-stage NSCLC. The preliminary data from ongoing trials suggest that the integration of checkpoint blockage into the treatment of early-stage and locally advanced NSCLC is safe, tolerable, and has the potential to improve outcomes without adding substantial toxicity. In the current review, we provide an overview of the emerging data on the role of PD-1/PD-L1 and cytotoxic T lymphocyte-associated protein 4 (CTLA-4) inhibitors in the treatment of early-stage and locally advanced NSCLC, with a focus on ongoing clinical trials and combination strategies.

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Acknowledgements

We thank Sonya J. Smyk, Moffitt Cancer Center, for editorial support. She received no compensation beyond her regular salary.

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  1. Department of Internal Medicine, Division of Hematology and Oncology, H. Lee Moffitt Cancer Center and Research Institute/University of South Florida, 12902 Magnolia Drive, GME 4th Floor, Tampa, FL, 33612, USA

    Sonam Puri MD

  2. Department of Thoracic Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612, USA

    Michael Shafique MD & Jhanelle E. Gray MD

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Sonam Puri declares that she has no conflict of interest. Michael Shafique has served on advisory boards for GlaxoSmithKline. Jhanelle E. Gray has received research funding through grants from Merck, AstraZeneca, Genentech, and Bristol-Myers Squibb, and has served on advisory boards for AstraZeneca.

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Puri, S., Shafique, M. & Gray, J.E. Immune Checkpoint Inhibitors in Early-Stage and Locally Advanced Non-Small Cell Lung Cancer. Curr. Treat. Options in Oncol. 19, 39 (2018). https://doi.org/10.1007/s11864-018-0556-7

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