Immunotherapy for Locally Advanced or Metastatic Non-Small Cell Lung Carcinoma

Orçun CANa , Gözde KAVGACIb , Saadettin KILIÇKAPa
aİstinye University Faculty of Medicine, Department of Medical Oncology, İstanbul, Türkiye
bHacettepe University Cancer Institute, Ankara, Türkiye

Can O, Kavgacı G, Kılıçkap S. Immunotherapy for locally advanced or metastatic non-small cell lung carcinoma. In: Şendur MAN, ed. Current Immunotherapy Landscape for Solid Tumors. 1st ed. Ankara: Türkiye Klinikleri; 2024. p.31-7.

ABSTRACT
Lung cancer is a leading cause of cancer-related deaths in Turkey, historically treated with chemotherapy with a limited impact on survival. The introduction of immune checkpoint inhibitors (ICIs) has transformed non-small cell lung cancer (NSCLC) treatment, significantly improving survival. Inoperable Stage III NSCLC patients are often treated with concurrent chemoradiotherapy (CCRT) followed by adjuvant durvalumab, but not all qualify, necessitating alternative therapies. Consolidation immunotherapy after CCRT or sequential CRT and concurrent immunotherapy with CRT shows promise in trials. For metastatic NSCLC with PD-L1 expression <50% combining chemotherapy with ICIs such as pembrolizumab and atezolizumab improves overall survival and progression-free survival. Metastatic NSCLC patients with PD-L1 expression ≥50% benefit significantly from ICIs alone or in conjunction with chemotherapy. Treatment decisions should be personalized, considering patient factors such as histology, PD-L1 status, mutational profiling, and medical history, with clinical trials playing a crucial role in advancing NSCLC therapy.

Keywords: Non-small-cell lung carcinoma; immunotherapy; immune checkpoint inhibitor

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