Immunotherapy for the treatment of lung cancer

Abstract

Traditionally, chemotherapy has been the fundamental treatment of advanced lung cancer without actionable mutations. Immunotherapy with antibodies inhibiting the immune checkpoints (ICI) revolutionized the treatment of lung cancer, releasing the brakes of the adaptive immune response against the tumor. Responses to ICI can be deep and lasting, obtaining long-term survivors. Currently, two anti-PD-1 antibodies (nivolumab and pembrolizumab) and two anti-PD-L1 (atezolizumab and durvalumab) are approved in several indications for non-small-cell lung cancer (NSCLC); and atezolizumab in the first-line of treatment of metastatic small-cell lung carcinoma, in combination with chemotherapy. However, biomarkers are necessary to optimize treatment efficiency. In this work we review the molecular basis and the evidence of the use of ICI in lung cancer, available biomarkers, tumor response assessment methods, immune-related adverse events, and future perspectives of immunotherapy for lung cancer.