PD-1 Blockade in Treatment of NSCLC: A Comprehensive Review of Clinical Efficacy, Safety and Cost-effective

Zeyue Li

doi:10.62051/anngda51

Authors

Zeyue Li

DOI:

https://doi.org/10.62051/anngda51

Keywords:

Programmed cell death 1 (PD-1); Immune checkpoint inhibitors (ICIs); non-small cell lung cancer (NSCLC); Nivolumab.

Abstract

Non-small cell lung cancer, also called NSCLC, makes up 85% incidence in lung cancer, presents a considerable challenge for its high mortality rate and poor prognosis. In recent years, the invention of programmed cell death 1 (PD-1) inhibitor nivolumab, which is a type of immune checkpoint inhibitors, emerging as a groundbreaking drug, has offered a potential solution to tackle the inescapable drawbacks of traditional cancer treatments. Several clinical trials assessing nivolumab's efficacy and safety in the form of monotherapy or combination therapy, demonstrated that nivolumab has remarkably increased the progression-free survival and overall survival for NSCC, in both first- and second-line. Notably, compared to chemotherapy drugs, nivolumab showed a favorable safety profile with fewer immune-related adverse events. Given the high cost and escalating use of nivolumab, finding more cost-effective treatment regimen is imperative. The purpose of this review is to delve into the clinical efficacy and safety of PD-1 inhibitor nivolumab as immunotherapy remedy against NSCLC, providing some therapeutic recommendations for cost-effective. While continued research and development are vital to further enhance nivolumab's potential as a more potent tool to combat cancer.

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References

Guo Q, Liu L, Chen Z, et al. Current treatments for non-small cell lung cancer. Front Oncol, 2022, 12: 945102.

Shiravand Y, Khodadadi F, Kashani SMA, et al. Immune Checkpoint Inhibitors in Cancer Therapy. Curr Oncol, 2022, 29 (5): 3044 – 3060.

Wojtukiewicz MZ, Rek MM, Karpowicz K, et al. Inhibitors of immune checkpoints—PD-1, PD-L1, CTLA-4—new opportunities for cancer patients and a new challenge for internists and general practitioners. Cancer Metastasis Rev, 2021, 40 (3): 949 – 982.

Carbone DP, Reck M, Paz-Ares L, et al. First-Line Nivolumab in Stage IV or Recurrent Non-Small-Cell Lung Cancer. N Engl J Med, 2017, 376 (25): 2415 – 2426.

Hellmann MD, Ciuleanu TE, Pluzanski A, et al. Nivolumab plus Ipilimumab in Lung Cancer with a High Tumor Mutational Burden. N Engl J Med, 2018, 378 (22): 2093 – 2104.

Brahmer J, Reckamp KL, Baas P, et al. Nivolumab versus Docetaxel in Advanced Squamous-Cell Non–Small-Cell Lung Cancer. N Engl J Med, 2015, 373 (2): 123 – 135.

Forde PM, Spicer J, Lu S, et al. Neoadjuvant Nivolumab plus Chemotherapy in Resectable Lung Cancer. N Engl J Med, 2022, 386 (21): 1973 – 1985.

Hellmann MD, Rizvi NA, Goldman JW, et al. Nivolumab plus ipilimumab as first-line treatment for advanced non-small-cell lung cancer (CheckMate 012): results of an open-label, phase 1, multicohort study. Lancet Oncol, 2017, 18 (1): 31 – 41.

Baldini E, Lunghi A, Cortesi E, et al. Immune-related adverse events correlate with clinical outcomes in NSCLC patients treated with nivolumab: The Italian NSCLC expanded access program. Lung Cancer, 2020, 140: 59 – 64.

Toi Y, Sugawara S, Kawashima Y, et al. Association of Immune‐Related Adverse Events with Clinical Benefit in Patients with Advanced Non‐Small‐Cell Lung Cancer Treated with Nivolumab. The Oncologist, 2018, 23 (11): 1358 – 1365.

Vaddepally R, Doddamani R, Sodavarapu S, et al. Review of Immune-Related Adverse Events (irAEs) in Non-Small-Cell Lung Cancer (NSCLC)—Their Incidence, Management, Multiorgan irAEs, and rechallenge. Biomedicines [Internet], 2022, 10 (4).

Wood LS. Immune Checkpoint Inhibitor Therapy: Key Principles When Educating Patients. Number 3 June 2019. 2019, 23 (3): 271 – 280.

Matter-Walstra K, Schwenkglenks M, Aebi S, et al. A Cost-Effectiveness Analysis of Nivolumab versus Docetaxel for Advanced Nonsquamous NSCLC Including PD-L1 Testing. J Thorac Oncol, 2016, 11 (11): 1846 – 1855.

Yoo SH, Keam B, Kim M, et al. Low-dose nivolumab can be effective in non-small cell lung cancer: alternative option for financial toxicity. ESMO Open, 2018, 3 (5): e000332.