Chemo-immunotherapy as first-line treatment for small-cell lung cancer

Abstract

Small-cell lung cancer (SCLC) is a highly lethal subtype of lung cancer. Despite concerted efforts over the past several decades, there have been limited therapeutic advances. Traditional chemotherapy offers a high response rate and rapid symptomatic improvement, but its benefit is fleeting, and relapse is quick and unforgiving. Immunotherapy has delivered improved outcomes for patients with many cancers and there was compelling rationale for development in SCLC. While initial efforts with cytotoxic T-lymphocyte protein-4 inhibitors failed to improve upon chemotherapy alone, the addition of programmed death ligand-1 (PD-L1) inhibitors to first-line chemotherapy finally provided long-awaited gains in survival. Atezolizumab, when added to carboplatin and etoposide, improved both progression-free survival and overall survival. Durvalumab, when added to platinum plus etoposide, similarly improved OS. Biomarker development has stalled as PD-L1 expression and tumor mutational burden have not been useful predictive biomarkers. However, based on the significant survival improvements, both atezolizumab and durvalumab were approved by the US Food and Drug Administration to be given with first-line chemotherapy, and these regimens represent the new standards of care for SCLC.

The Prognostic Value of GNG7 in Colorectal Cancer and Its Relationship With Immune Infiltration

“…At present, with the in-depth understanding of the mechanism of tumor immune infiltration, the tumor immunotherapy has also been rapidly developed. In particular, tumor immunotherapy has yielded significant effects in a variety of cancer types ( Rosenberg et al, 2019 ; Brewer et al, 2020 ; Farid and Liu 2020 ).…”

Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses

“… 11 , 12 Adding both the PD-L1 agents atezolizumab and durvalumab to CT led to the first OS improvement in the first-line setting of ES-SCLC. 13 Conversely, although being associated with improved landmark survival rates at 12 and 24 months that consistently mirrored the favorable trends of PD-L1 agents, the median OS of the PD-1 inhibitor pembrolizumab in association with CT did not cross the pre-specified threshold for a survival benefit. 13 Furthermore, nivolumab in combination with CT significantly improved survival rates; however, only immature data was presented in the EA5161 phase II study.…”

“… 13 Conversely, although being associated with improved landmark survival rates at 12 and 24 months that consistently mirrored the favorable trends of PD-L1 agents, the median OS of the PD-1 inhibitor pembrolizumab in association with CT did not cross the pre-specified threshold for a survival benefit. 13 Furthermore, nivolumab in combination with CT significantly improved survival rates; however, only immature data was presented in the EA5161 phase II study. Moreover, unfortunately, no accurate predictive biomarkers that can precisely guide the use of ICIs in such patients have been identified.…”

Combined Chemo–Immuno–Photothermal Therapy for Effective Cancer Treatment via an All-in-One and One-for-All Nanoplatform

“…Due to its outstanding biocompatibility, in vivo biodegradability, nontoxicity, and the ability of self-assembly, zein was categorized as one of the safest biomaterials by the US FDA . However, the NPs-assisted chemotherapy was still challenged by the emergence of drug resistance and incomplete elimination of the tumor, which ultimately leads to recurrence and treatment failure . Therefore, combinational therapy has been proposed in recent years with an expectation to improve the therapeutic efficacy, such as combining chemotherapy with photothermal therapy (PTT), photodynamic therapy (PDT), or immunotherapy.…”