Cancer immunotherapies have revolutionized the treatment of non–small cell lung cancer. Yet, only a small subset of patients will benefit from PD-1 or PD-L1 blockade. PD-L1 tumor cell expression is the only approved biomarker at present. Tumor mutational burden and other emerging biomarkers should improve patient selection. Combination therapy approaches with chemotherapy or cytotoxic T-lymphocyte-associated protein 4 blockade may increase the proportion of patients who benefit from immunotherapy. Although use of immunotherapy in lung cancers with targetable oncogenes has not been particularly successful, the benefit of PD-(L)1 inhibitors in early-stage disease is emerging. This review briefly describes the evolution of the clinical development and future directions of PD-(L)1 blockade in patients with lung cancers.
From the *Division of Medical Oncology, Instituto do Cancer do Estado de São Paulo, and Hospital Sírio Libanês, São Paulo, Brazil; †Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center; and ‡Department of Medicine, Weill Cornell Medical College, New York, NY; and §Parker Institute for Cancer Immunotherapy, San Francisco, CA.
The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.
Reprints: Matthew D. Hellmann, MD, Memorial Sloan Kettering Cancer Center, 885 2nd Ave, 10th Floor, New York, NY 10017. E-mail: firstname.lastname@example.org.