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Immune checkpoint inhibitors in epidermal growth factor receptor mutant non-small cell lung cancer: Current controversies and future directions

Authors
 Ross A Soo  ;  Sun Min Lim  ;  Nicholas L Syn  ;  Rebecca Teng  ;  Richie Soong  ;  Tony S K Mok  ;  Byoung Chul Cho 
Citation
 LUNG CANCER, Vol.115 : 12-20, 2018 
Journal Title
 LUNG CANCER 
ISSN
 0169-5002 
Issue Date
2018
Keywords
Epidermal growth factor receptor mutations ; Immune checkpoint inhibitors ; Non-small cell lung cancer ; Programmed death ligand-1 ; Tyrosine kinase inhibitors
Abstract
Major advances with the development of epidermal growth factor receptor tyrosine kinase inhibitors and immune check-point inhibitors have ushered in a new era in lung cancer therapy. Whilst pre-clinical studies suggest EGFR-driven NSCLC inhibit antitumor immunity through the activation of the PD-1/PD-L1 pathway, epidemiology studies suggest EGFR mutant NSCLC are more likely to have decreased PD-L1 expression. The superiority of single agent PD-1/PD-L1 inhibitors over docetaxel in pre-treated EGFR mutant NSCLC appears to be moderated. Several mechanisms for a poor response to immune checkpoint have been proposed including a lower tumor mutation burden, and an uninflamed and immunosuppressive tumor microenvironment. Predictive biomarkers to PD-1/PD-L1 inhibitors sensitivity in patients with EGFR mutations are required. The role of EGFR TKI in combination with an immune checkpoint inhibitor is currently being investigated intensively in multiple clinical trials and outcomes from these trials are immature and the optimal sequence, schedule and dosing remains to be determined. A careful evaluation will be required in view of the increased toxicities reported in some of the early studies of combination therapy.
Full Text
https://www.sciencedirect.com/science/article/pii/S0169500217305664
DOI
10.1016/j.lungcan.2017.11.009
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Cho, Byoung Chul(조병철) ORCID logo https://orcid.org/0000-0002-5562-270X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161879
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